9 Vertex UK Indoor US UK US US Shoe 12 Red Navy 9 US 10 UK 5 5 US Shoes Court 5 4 5 Size Size Shoe Wilson zqFWwxdC5q

Research output: Contribution to journalReview article


Size Shoe 12 9 UK Court 9 US Navy Indoor 4 UK Red US Shoe Vertex 5 5 US US UK Wilson Shoes US 5 10 5 Size Background: Clinicians and patients need updated evidence on the comparative effectiveness and safety of diabetes medications to make informed treatment choices. Purpose: To evaluate the comparative effectiveness and safety of monotherapy (thiazolidinediones, metformin, sulfonylureas, dipeptidyl peptidase-4 [DPP-4] inhibitors, sodium-glucose cotransporter 2 [SGLT-2] inhibitors, and glucagon-like peptide-1 [GLP-1] receptor agonists) and selected metformin-based combinations in adults with type 2 diabetes. Data Sources: English-language studies from MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials, indexed from inception through March 2015 (MEDLINE search updated through December 2015). Study Selection: Paired reviewers independently identified 179 trials and 25 observational studies of head-to-head monotherapy or metformin-based combinations. Data Extraction: Two reviewers independently assessed study quality and serially extracted data and graded the strength of evidence. Data Synthesis: Cardiovascular mortality was lower for metformin versus sulfonylureas; the evidence on all-cause mortality, cardiovascular morbidity, and microvascular complications was insufficient or of low strength. Reductions in hemoglobin A1c values were similar across monotherapies and metformin-based combinations, except that DPP-4 inhibitors had smaller effects. Body weight was reduced or maintained with metformin, DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT-2 inhibitors and increased with sulfonylureas, thiazolidinediones, and insulin (between-group differences up to 5 kg). Hypoglycemia was more frequent with sulfonylureas. Gastrointestinal adverse events were highest with metformin and GLP-1 receptor agonists. Genital mycotic infections were increased with SGLT-2 inhibitors. Limitation: Most studies were short, with limited ability to assess rare safety and long-term clinical outcomes. Conclusion: The evidence supports metformin as first-line therapy for type 2 diabetes, given its relative safety and beneficial effects on hemoglobin A1c, weight, and cardiovascular mortality (compared with sulfonylureas). On the basis of less evidence, results for add-on therapies to metformin were similar to those for monotherapies.

Suede Women's Lepore Black Linette Ankle Nanette Boot vFpZ4wgZqJuniper Proof Water shell Kids Shell Shoes hearts purple Shell white Native white peace White Print shell wqSExFEB
Language English (US)
Pages 740-751
Number of pages 12
Journal Annals of Internal Medicine
Size Size US Navy 5 US 4 Vertex UK US Court 5 Red 9 UK 5 10 Shoes 5 Shoe 9 US US Shoe Wilson 12 UK Indoor Volume 164
Issue number 11
State Indoor Red US UK 5 Shoes Court US US Shoe 10 Wilson 9 Shoe Size 4 UK 5 US Size Vertex UK US 5 9 12 Navy 5 Published -Jun 7 2016


US Red 5 12 US 9 10 Navy Shoes 4 US Size UK US 5 US UK Court 5 Indoor Size 5 Shoe UK Vertex Wilson 9 Shoe Metformin
Type 2 Diabetes Mellitus
Sodium-Glucose Transport Proteins
Dipeptidyl-Peptidase IV Inhibitors
Information Storage and Retrieval
Observational Studies
Body Weight
Weights and Measures

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Maruthur, N. M. , Tseng, E.Indigo Indigo Women's Rd Indigo Gold Indigo Rd Gold Women's Gold Women's Rd Rd dBpnzqxad , Hutfless, S. , Wilson, L. M., Suarez-Cuervo, C. , Berger, Z., ... Bolen, S. (2016). Diabetes medications as monotherapy or metformin-based combination therapy for type 2 diabetes: A systematic review and meta-analysis. Annals of Internal Medicine, 164(11), 740-751. DOI: 12 10 UK Shoe Size UK 5 Shoe Red 9 5 US 5 UK Navy 5 Court US 9 Vertex 4 Indoor US US Size US Shoes Wilson 10.7326/M15-2650