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Cited by 17Diabetes Treatment and ManagementDiabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and Research

Metformina para la diabetes mellitus tipo 2. Revisión sistemática y metaanálisis

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Sáenz Calvo, A., Fernández Esteban, I., Mataix Sanjuán, A., Ausejo Segura, M., Roqué, M., Moher, D.·2005·Atención Primaria
DOI 10.1157/13078602PMC PMC7684484
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Abstract

Objective To evaluate the efficacy of metformin against placebo, diet, oral anti-diabetics, or insulin in type 2 diabetes mellitus.Design Systematic review.Data sources MEDLINE (1966-2003), EMBASE (1974-2003), LILACS (1986-2003), Cochrane library (Issue 3, 2003).Selection of studies 29 randomized clinical trials of metformin in monotherapy, with results on mortality, morbidity, and biochemistry. EXTRACTION OF DATA: RevMan 4 computer program. Two reviewers extracted the data and evaluated the quality.Main variables any clinical event related to diabetes (mortality, coronary disease, stroke, arterial disease, and retinopathy). Secondary variables: weight and biochemistry.Results 29 clinical studies with 37 comparisons of metformin were analyzed (13 with sulphonylureas, 12 with placebo, 3 with diet, 3 with thiazolidinediones, 2 with alpha-glucosidase inhibitors, 2 with insulin, and 2 with meglitinides). Metformin was more beneficial than the sulphonylureas or insulin for any clinical event associated with diabetes (relative risk [RR]=0.78; 95% confidence interval [CI], 0.65-0.94) and than diet (RR=0.74; 95% CI, 0.60-0.90). Metformin decreased glycosylated hemoglobin A1 (weighted mean difference, -1.21%; 95% CI, -1.48 to -0.94), low density lipoprotein cholesterol (weighted mean difference, -0.24; 95% CI, -0.40 to -0.09), and weight (standardized mean difference, -0.11; 95% CI, -0.18 to -0.04). Metformin was more beneficial than the placebo, diet or the thiazolidinediones on glycosylated hemoglobin A1, and than the sulphonylureas or insulin on weight.Conclusions In the long term metformin reduces the risks of clinical events associated with diabetes. There are no long term clinical trials which compare alpha-glucosidase inhibitors, meglitinides, and thiazolidinediones with metformin, in primary results. The different treatments compared with metformin did not obtain more benefit for the secondary results evaluated.

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  • Metformin is a highly effective and widely adopted intervention for both managing T2D and preventing its onset in high-risk individuals.

    “Metformin is a highly effective and widely adopted intervention for both managing type 2 diabetes (T2D) and preventing its onset in high-risk individuals [20,27].”

    From Economic evaluation of wearable fitness trackers versus metformin for preventing type 2 diabetes in the UK population (2025) · cites this paper as [27]

    The paper’s “Lo conocido sobre el tema” and “Qué aporta este estudio” sections describe metformin as a first-line treatment for type 2 diabetes and report beneficial effects on blood glucose. They discuss preventing vascular complications in people who already have diabetes, not preventing the onset of diabetes in high-risk individuals. Page numbers are unavailable for these passages. (LLM, conf=0.88)

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Research works printed but not linked: 3

  1. Richter B, Berger M, Bergerhoff K, Clar C, De Leiva A, Man- ning P, et al. Cochrane Metabolic and Endocrine Disorders Group. En: Cochrane Library, Issue 3. Oxford: Update Softwa- re, 2001.
  2. Bailey CJ, Turner RC. Drug therapy: metformin. N Engl J Med. 1996;334:574-9.
  3. Dalzell GW, Hadden DR, Atkinson AB, Kennedy L, Weavwe JA. A randomized trial tolbutamide and metformin for persis- tent severe hyperglycaemia in non insulin dependent diabetes mellitus (NIDDM). Irish J Med Sci. 1986;155:341-2.

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Authors
Sáenz Calvo, A., Fernández Esteban, I., Mataix Sanjuán, A., Ausejo Segura, M., Roqué, M., & Moher, D.
Affiliations
Children's Hospital of Eastern Ontario (CA)
ORCID
Moher, D.
Venue
Atención Primaria
Publisher
Elsevier BV
Published
2005-07
Volume
36
Issue
4
Pages
183-191
ISSN
0212-6567 (ISSN-L)
DOI
10.1157/13078602
PMC
PMC7684484
OpenAlex
W2051969212
Cited by
17
References
49
Citations by year
2025: 2 · 2018: 2 · 2014: 2 · 2012: 2
FWCI
0.83
Type
journal article
Language
es
Open access
Licence
Locations
  • Atención Primaria (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
metformin, type 2 diabetes, monotherapy, sulfonilureas, insulin, diet, thiazolidinediones, alpha-glucosidase inhibitors, meglitinides, HbA1c, LDL cholesterol, body weight, diabetes mortality, cardiovascular complications, kidney disease, retinopathy, diabetic neuropathy, drug safety, adverse events
MeSH terms
Adult, Aged, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Cholesterol, LDL, Male, Metformin, Middle Aged, Placebos, Risk, Risk Factors, Time Factors, Confidence Intervals, Chi-Square Distribution, Randomized Controlled Trials as Topic

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