A model-based meta-analysis of 24 antihyperglycemic drugs for type 2 diabetes: comparison of treatment effects at therapeutic doses
Abstract
Model-based meta-analysis was used to compare glycemic control, weight changes, and hypoglycemia risk across 24 antihyperglycemic drugs used to treat type 2 diabetes. Electronic searches identified 229 randomized controlled studies comprising 121,914 patients. To ensure fair and unbiased treatment comparisons, the analyses adjusted for important differences between studies, including duration of treatment, baseline glycated hemoglobin, and drug dosages. At the approved doses, glycemic control was typically greatest with glucagon-like peptide 1 receptor agonists (GLP-1RAs), and least with dipeptidyl peptidase-4 (DPP-4) inhibitors. Weight loss was highly variable across GLP-1RAs but was similar across sodium-glucose cotransporter 2 (SGLT2) inhibitors. Large weight increases were observed with sulfonylureas and thiazolidinediones. Hypoglycemia risk was highest with sulfonylureas, although gliclazide was notably lower. Hypoglycemia risk for DPP-4 inhibitors, SGLT2 inhibitors, and thiazolidinediones was generally very low but increased slightly for both GLP-1RAs and metformin. In summary, important differences between and within drug classes were identified.
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Addition of GLP-1 RAs or the dual GIP and GLP-1 RA to metformin usually results in 1 to ≥2% lowering of A1C.
“Addition of GLP-1 RAs or the dual GIP and GLP-1 RA to metformin usually results in 1 to $2% lowering of A1C (104,117,118) (Fig. 9.3 and Table 9.2).”
From 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2025 (2025) · cites this paper as [118]
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- Authors
- Maloney, A., Rosenstock, J., & Fonseca, V.
- Affiliations
- Equation AB Halmstad Sweden
- Dallas Diabetes Research Center (US)
- Tulane University (US)
- Corresponding author
- Maloney, Alan
- Venue
- Clinical Pharmacology & Therapeutics
- Publisher
- Wiley
- Published
- 2019-01-13
- Volume
- 105
- Issue
- 5
- Pages
- 1213-1223
- ISSN
- 0009-9236 (ISSN-L)
- 1532-6535
- OpenAlex
- W2901511101
- Cited by
- 115
- References
- 9
- Citations by year
- 2026: 6 · 2025: 12 · 2024: 22 · 2023: 15 · 2022: 15 · 2021: 18 · 2020: 20 · 2019: 7
- FWCI
- 1.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Pharmacology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Keywords
- type 2 diabetes, antidiabetic drugs, glycemic control, weight change, hypoglycemia risk, GLP-1 receptor agonists, DPP-4 inhibitors, SGLT2 inhibitors, sulfonylureas, thiazolidinediones, metformin, gliclazide, drug class comparison
- MeSH terms
- Diabetes Mellitus, Type 2, Dose-Response Relationship, Drug, Humans, Hypoglycemia, Hypoglycemic Agents, Randomized Controlled Trials as Topic, Risk Assessment
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