Comparing Medications for Adults With Type 2 Diabetes
Details of the HbA1c and Weight Intermediate Outcomes: Monotherapy versus Two-Drug Combination Therapy
All combination therapies were better at reducing HbA1c than monotherapy regimens, with between-group differences of about 1 percent. The strength of evidence was rated high for metformin versus metformin plus thiazolidinediones, and metformin versus metformin plus sulfonylureas, and graded moderate for metformin versus metformin plus DPP-4 inhibitors.
Metformin monotherapy had a more favorable effect on weight compared with the combination of metformin plus a thiazolidinedione (between-group difference of -2.2 kg, 95 percent CI, -2.6 kg to -1.9 kg) or metformin plus a sulfonylurea (pooled between-group difference of -2.3 kg, 95 percent CI, -3.3 kg to -1.2 kg). The strength of evidence was graded high for these comparisons. Metformin monotherapy had no significant differences in weight when compared with the combination of metformin plus DPP-4 inhibitors (pooled between-group difference of -0.2 kg, 95 percent CI, -0.7 kg to 0.2 kg). The strength of evidence was graded moderate for this comparison.
Keywords: body weight | combination therapy | intermediate outcomes | monotherapy | hemoglobin A1c (HbA1c)
- 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.
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