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Comparing Medications for Adults With Type 2 Diabetes

Slide: 21 of 35

Details of the Lipid Intermediate Outcomes: Monotherapy versus Two-Drug Combination Therapy

Lipids
The addition of rosiglitazone to metformin increased LDL and HDL but also increased TG when compared to metformin monotherapy. The addition of DPP-4 inhibitors to metformin did not have an effect on HDL in comparison with metformin monotherapy.

LDL
The combination of metformin and rosiglitazone increased LDL compared to metformin monotherapy (pooled between-group difference of 14.5  mg/dL, 95 percent CI, 13.3 mg/dL to 15.7 mg/dL), with high strength of evidence.

HDL
The combination of rosiglitazone and metformin increased HDL relative to metformin monotherapy (pooled between-group difference of 2.8  mg/dL, 95 percent CI, 2.2 mg/dL to 3.5 mg/dL), with high strength of evidence. The combination of metformin and DPP-4 inhibitors did not affect HDL relative to metformin monotherapy. The pooled between-group difference in HDL for metformin compared to the combination of metformin and saxagliptin was 0.5 mg/dL (95 percent CI, -1.5 mg/dL to 2.5 mg/dL) with moderate strength of evidence. The combination of metformin plus pioglitazone was favored over metformin monotherapy with a low strength of evidence.

TG
Metformin monotherapy decreased TG compared to the combination of metformin and rosiglitazone (pooled between-group difference -14.5  mg/dL, 95 percent CI, -15.7 mg/dL to -13.3 mg/dL), with high strength of evidence.