CoChat
Sign Up
Cited by 609Diabetes Treatment and ManagementDiabetes Management and ResearchDiabetes, Cardiovascular Risks, and Lipoproteins

The DOI matches its Crossref record; 15 of the 15 references it cites were found in a registry or an index.

Comparative Effectiveness and Safety of Medications for Type 2 Diabetes: An Update Including New Drugs and 2-Drug Combinations

Open access
Bennett, Wendy L., Maruthur, Nisa M., Singh, Sonal, Segal, Jodi B., Wilson, Lisa M., Chatterjee, Ranee, Marinopoulos, Spyridon S., Puhan, Milo A., Ranasinghe, Padmini, Block, Lauren, Nicholson, Wanda K., Hutfless, Susan, Bass, Eric B., Bolen, Shari·2011·Annals of Internal Medicine
DOI 10.7326/0003-4819-154-9-201105030-00336PMC PMC3733115
Open this paper in CoChat — free account

Abstract

BACKGROUND: Given the increase in medications for type 2 diabetes mellitus, clinicians and patients need information about their effectiveness and safety to make informed choices. PURPOSE: To summarize the benefits and harms of metformin, second-generation sulfonylureas, thiazolidinediones, meglitinides, dipeptidyl peptidase-4 (DPP-4) inhibitors, and glucagon-like peptide-1 receptor agonists, as monotherapy and in combination, to treat adults with type 2 diabetes. DATA SOURCES: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched from inception through April 2010 for English-language observational studies and trials. The MEDLINE search was updated to December 2010 for long-term clinical outcomes. STUDY SELECTION: Two reviewers independently screened reports and identified 140 trials and 26 observational studies of head-to-head comparisons of monotherapy or combination therapy that reported intermediate or long-term clinical outcomes or harms. DATA EXTRACTION: Two reviewers following standardized protocols serially extracted data, assessed applicability, and independently evaluated study quality. DATA SYNTHESIS: Evidence on long-term clinical outcomes (all-cause mortality, cardiovascular disease, nephropathy, and neuropathy) was of low strength or insufficient. Most medications decreased the hemoglobin A(1c) level by about 1 percentage point and most 2-drug combinations produced similar reductions. Metformin was more efficacious than the DPP-4 inhibitors, and compared with thiazolidinediones or sulfonylureas, the mean differences in body weight were about -2.5 kg. Metformin decreased low-density lipoprotein cholesterol levels compared with pioglitazone, sulfonylureas, and DPP-4 inhibitors. Sulfonylureas had a 4-fold higher risk for mild or moderate hypoglycemia than metformin alone and, in combination with metformin, had more than a 5-fold increased risk compared with metformin plus thiazolidinediones. Thiazolidinediones increased risk for congestive heart failure compared with sulfonylureas and increased risk for bone fractures compared with metformin. Diarrhea occurred more often with metformin than with thiazolidinediones. LIMITATIONS: Only English-language publications were reviewed. Some studies may have selectively reported outcomes. Many studies were small, were of short duration, and had limited ability to assess clinically important harms and benefits. CONCLUSION: Evidence supports metformin as a first-line agent to treat type 2 diabetes. Most 2-drug combinations similarly reduce hemoglobin A(1c) levels, but some increased risk for hypoglycemia and other adverse events. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.7326/0003-4819-154-9-201105030-00336

Cites

15 of 15 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • 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 [117]

    The Results section (Comparative Effectiveness for Intermediate Outcomes; page not provided) reports that two-drug combinations lowered HbA1c by about one percentage point more than monotherapy and that, on low-strength evidence, metformin plus a GLP-1 agonist lowered HbA1c more than metformin plus a DPP-4 inhibitor. It does not establish a usual 1 to ≥2 percentage-point reduction specifically for GLP-1 add-on therapy, and the passages do not address dual GIP/GLP-1 agonists. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Flagged first, then by citations

Research works printed but not linked: 40

  1. 10.1001/archinte.168.19.2088 · DOI
  2. 10.7326/0003-4819-128-3-199802010-00001 · DOI · Paper page
  3. 10.1016/0168-8227(95)01064-K · DOI · Paper page
  4. 10.1016/S0140-6736(98)07037-8 · DOI · Paper page
  5. Shichiri M, 2000, Diabetes Care, 23, B21
  6. 10.7326/0003-4819-147-6-200709180-00178 · DOI
  7. 10.1002/sim.1761 · DOI · Paper page
  8. 10.1136/bmj.315.7109.629 · DOI · Paper page
  9. 10.1016/S0140-6736(09)60953-3 · DOI · Paper page
  10. 10.1111/j.1463-1326.2010.01204.x · DOI
  11. 10.1002/dmrr.264 · DOI
  12. 10.1016/j.clinthera.2005.10.012 · DOI · Paper page
  13. 10.1185/030079905X74844 · DOI
  14. 10.1111/j.1463-1326.2006.00659.x · DOI
  15. 10.1111/j.1464-5491.2006.01942.x · DOI
  16. 10.1001/jama.283.13.1695 · DOI
  17. 10.1046/j.1463-1326.2003.00258.x · DOI
  18. 10.1016/j.diabres.2007.08.024 · DOI
  19. 10.1001/jama.2010.405 · DOI · Paper page
  20. 10.4158/EP.15.6.540 · DOI · Paper page
  21. Richter B, 2008, Cochrane Database Syst Rev, CD006739
  22. 10.1016/j.ccl.2008.06.008 · DOI
  23. 10.1530/EJE-09-0101 · DOI
  24. 10.1001/jama.2010.920 · DOI
  25. 10.1136/bmj.b2942 · DOI
  26. 10.1001/archinternmed.2010.207 · DOI
  27. 10.1056/NEJMp1008233 · DOI
  28. Richter B, 2007, Cochrane Database Syst Rev, CD006063
  29. 10.1001/archinte.168.19.2070 · DOI · Paper page
  30. 10.1056/NEJMp1010788 · DOI
  31. 10.7326/0003-4819-133-6-200009190-00014 · DOI · Paper page
  32. Black C, 2007, Cochrane Database Syst Rev, CD004654
  33. 10.1016/S0140-6736(05)67528-9 · DOI · Paper page
  34. 10.7326/0003-4819-128-3-199802010-00001 · DOI · Paper page
  35. 10.2337/diab.34.8.793 · DOI
  36. 10.1136/bmj.310.6972.83 · DOI · Paper page
  37. 10.1001/jama.299.13.1561 · DOI · Paper page
  38. 10.1111/j.1523-1755.2005.00416.x · DOI
  39. 10.2165/11316510-000000000-00000 · DOI
  40. 10.2337/diacare.25.11.2058 · DOI

Cited by

Sorted by citations

Metadata

Authors
Bennett, W. L., Maruthur, N. M., Singh, S., Segal, J. B., Wilson, L. M., Chatterjee, R., Marinopoulos, S. S., Puhan, M. A., Ranasinghe, P., Block, L., Nicholson, W. K., Hutfless, S., Bass, E. B., & Bolen, S.
Affiliations
University of North Carolina at Chapel Hill (US)
ORCID
Venue
Annals of Internal Medicine
Publisher
American College of Physicians
Published
2011-05-03
Volume
154
Issue
9
Pages
602-613
ISSN
  • 0003-4819 (ISSN-L)
  • 1539-3704
DOI
10.7326/0003-4819-154-9-201105030-00336
PMC
PMC3733115
OpenAlex
W2107222124
Cited by
609
References
15
Citations by year
2026: 9 · 2025: 18 · 2024: 19 · 2023: 25 · 2022: 32 · 2021: 27 · 2020: 33 · 2019: 31 · 2018: 43 · 2017: 50 · 2016: 57 · 2015: 60 · 2014: 57 · 2013: 60 · 2012: 60
FWCI
8.97
Type
journal article
Language
en
Open access
Licence
www.acpjournals.org/journal/aim/text-and-data-mining (tdm)
Locations
  • Annals of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Heart, Lung, and Blood Institute (K23HL098476)
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 › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
type 2 diabetes, antidiabetic drugs, comparative effectiveness, drug safety, metformin, sulfonylureas, thiazolidinediones, meglitinides, DPP-4 inhibitors, GLP-1 receptor agonists, combination therapy, glycemic control, hypoglycemia, congestive heart failure, bone fractures, kidney disease, neuropathy
MeSH terms
Body Weight, Diabetes Mellitus, Type 2, Drug Therapy, Combination, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Lipids, Publication Bias, Comparative Effectiveness Research

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review