Comparing Medications for Adults With Type 2 Diabetes
Other Adverse Events and Side Effects: Comparisons of Monotherapies
High-grade evidence showed that rates of liver injury are similar between thiazolidinediones and sulfonylureas. Moderate-grade evidence showed that the rates of liver injury are similar between thiazolidinediones and metformin.
Hip and Nonhip Fractures
High-grade evidence showed that thiazolidinediones, either in combination with another medication or as monotherapy, are associated with a higher risk of bone fractures compared with metformin alone or in combination with sulfonylurea.
Congestive Heart Failure
Moderate evidence showed that thiazolidinediones increase the risk of heart failure when compared to sulfonylureas. There were no long-term trials that provide a robust assessment of the comparative safety of the DPP-4 inhibitors and GLP-1 receptor agonists on the risk of heart failure.
Severe Lactic Acidosis
Moderate strength of evidence indicated that there is no increased risk of lactic acidosis in metformin users compared to those using a sulfonylurea or a combination of metformin and a sulfonylurea.
Keywords: adverse events | congestive heart failure | fractures | lactic acidosis | monotherapy | liver injury
- Bennett WL, Wilson LM, Bolen S, et al. Oral Diabetes Medications for Adults With Type 2 Diabetes: An Update. Comparative Effectiveness Review No. 27. (Prepared by Johns Hopkins University Evidence-based Practice Center under Contract No. 290-02-0018.) AHRQ Publication No. 11-EHC038-EF. Rockville, MD: Agency for Healthcare Research and Quality. March 2011. Available at: http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=644.
- Bolen S, Wilson L, Vassy J, et al. Comparative Effectiveness and Safety of Oral Diabetes Medications for Adults With Type 2 Diabetes. Comparative Effectiveness Review No. 8. (Prepared by Johns Hopkins Evidence-based Practice Center under Contract No. 290-02-0018.) Rockville, MD: Agency for Healthcare Research and Quality. July 2007. Available at:http://www.effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productid=40.
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