No Mortality Difference Among Glucose-Lowering Drugs
A meta-analysis has determined that metformin is still the first-line treatment for diabetes.
HealthDay News — There are no significant differences in the associations between available glucose-lowering drugs (alone or in combination) and the risk of cardiovascular or all-cause mortality, according to a review published in the Journal of the American Medical Association.
Suetonia Palmer, PhD, an associate professor in the Department of Medicine at the University of Otago in New Zealand, and colleagues analyzed results from 301 clinical trials testing 9 classes of diabetes drugs. Many trials tested only a single medication, but over 100 studies used a drug in combination with metformin.
Overall, metformin worked as well, or better, than other drugs when it came to reducing blood glucose levels. When it came to preventing complications or lengthening patients' lives, no single drug or drug combination stood out.
"Metformin was associated with lower or no significant difference in hemoglobin A1c levels compared with any other drug classes. All drugs were estimated to be effective when added to metformin," the authors conclude. "These findings are consistent with American Diabetes Association recommendations for using metformin monotherapy as initial treatment for patients with type 2 diabetes and selection of additional therapies based on patient-specific considerations."
- 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(3):313-324; doi: 10.1001/jama.2016.9400.