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Existing evidence is insufficient to justify metformin or other agents as first-line therapy for type 2 diabetes
Commentary on: Palmer SC, Mavridis D, Nicolucci A, et al.. Comparison of clinical outcomes and adverse events associated with glucose-lowering drugs in patients with type 2 diabetes: a meta-analysis. JAMA 2016;316:313–324 . Context A broad consensus supports the use of metformin as first-line therapy for patients with type 2 diabetes. Clinicians and patients, however, may be interested in using newer antihyperglycaemic drugs as first-line treatment, but their relative advantages to metformin—beyond burden of treatment and hypoglycaemic potential—remain uncertain. The systematic review by Palmer et al soug...
Source: Evidence-Based Medicine - November 22, 2016 Category: Internal Medicine Authors: Rodriguez-Gutierrez, R., Montori, V. M. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Ischaemic heart disease, Diabetes Therapeutics/Prevention Source Type: research

Metformin associated with better cardiovascular outcomes than other glycaemic therapies
Context A question exists as to whether the outcome of glycaemic treatment of diabetes varies with the agent used; speculation surrounds whether metformin might be preferable to other treatments. Methods Ghotbi and colleagues performed an epidemiological analysis of 8192 obese patients with diabetes at increased cardiovascular risk participating in the Sibutramine Cardiovascular OUTcomes (SCOUT) trial. Mortality and a combined cardiovascular outcome of non-fatal myocardial infarction, non-fatal stroke, resuscitation after cardiac arrest or cardiovascular death were compared among those receiving one of the following interv...
Source: Evidence-Based Medicine - May 19, 2014 Category: Internal Medicine Authors: Bloomgarden, Z. T. Tags: Smoking and tobacco, Epidemiologic studies, Drugs: cardiovascular system, Heart failure, Stroke, Hypertension, Diet, Obesity (nutrition), Ischaemic heart disease, Diabetes, Health education, Smoking Therapeutics Source Type: research

Metformin may not reduce cardiovascular risk or all-cause mortality
Commentary on: Boussageon R, Supper I, Bejan-Angoulvant T, et al.. Reappraisal of metformin efficacy in the treatment of Type 2 diabetes: a meta-analysis of randomised controlled trials. PLoS Med 2012;9:268–82. Context The treatment of hyperglycaemia is considered as one of the tools for preventing cardiovascular disease in Type 1 and Type 2 diabetic (T2D) patients.1 2 Metformin is recommended as the first-line drug for T2D by most international guidelines (IDF.2005. http://www.idf.org, 2007. http://www.aace.com, http://www.diabetesjournals.org, http://www.nice.org.uk/CG66). The preference for metformin over other av...
Source: Evidence-Based Medicine - March 19, 2013 Category: Internal Medicine Authors: Monami, M. Tags: Geriatric medicine, Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Diet, Ischaemic heart disease, Diabetes Online articles Source Type: research