Comparing Medications for Adults With Type 2 Diabetes
Intermediate Outcomes: Overview of Lipid Results
The effects on lipid levels varied across medication type, but most were small to moderate, in studies that lasted between 3 and 12 months. For instance, pooled analyses showed between-group differences of around 5 to 10 mg/dL in low-density lipoproteins (LDL), 10 to 30 mg/dL in triglycerides (TG), and 3 to 5 mg/dL in high-density lipoproteins (HDL). In general, metformin had favorable effects on all the lipid classes. This updated review contributes to the literature by including DPP-4 inhibitors and GLP-1 receptor agonists for lipid outcomes. However, insufficient or low strength of evidence was found for most of these comparisons because of the limited number of studies. Similar to the 2007 review, results demonstrated that one medication or class may have favorable effects on one lipid outcome and unfavorable effects on another lipid outcome. Varying effects on lipid fractions such as these may account for differences in cardiovascular risk between medications. Decisions regarding medications that may adversely affect lipids are important because of the importance of cardiovascular disease risk reduction in patients with diabetes.
- 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.
- Hu FB, Stampfer MJ, Solomon CG, et al. The impact of diabetes mellitus on mortality from all causes and coronary heart disease in women: 20 years of follow-up. Arch Intern Med 2001;161(14):1717-1723.
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