CoChat
Sign Up
Cited by 102Diabetes Treatment and ManagementDiabetes Management and ResearchDiabetes, Cardiovascular Risks, and Lipoproteins

Newer pharmacologic treatments in adults with type 2 diabetes: a clinical guideline from the American College of Physicians.

Open access
Qaseem, Amir, Obley, Adam J., Shamliyan, Tatyana, Hicks, Lauri A., Harrod, Curtis S., Crandall, Carolyn J., Clinical Guidelines Committee of the American College of Physicians, Balk, Ethan M. +32 more·2024·Annals of Internal Medicine
DOI 10.7326/m23-2788PMC PMC11614146
Open this paper in CoChat — free accountOpen PDF

Abstract

DESCRIPTION: The American College of Physicians (ACP) developed this clinical guideline to update recommendations on newer pharmacologic treatments of type 2 diabetes. This clinical guideline is based on the best available evidence for effectiveness, comparative benefits and harms, consideration of patients' values and preferences, and costs. METHODS: This clinical guideline is based on a systematic review of the effectiveness and harms of newer pharmacologic treatments of type 2 diabetes, including glucagon-like peptide-1 (GLP-1) agonists, a GLP-1 agonist and glucose-dependent insulinotropic polypeptide agonist, sodium-glucose cotransporter-2 (SGLT-2) inhibitors, dipeptidyl peptidase-4 (DPP-4) inhibitors, and long-acting insulins, used either as monotherapy or in combination with other medications. The Clinical Guidelines Committee prioritized the following outcomes, which were evaluated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach: all-cause mortality, major adverse cardiovascular events, myocardial infarction, stroke, hospitalization for congestive heart failure, progression of chronic kidney disease, serious adverse events, and severe hypoglycemia. Weight loss, as measured by percentage of participants who achieved at least 10% total body weight loss, was a prioritized outcome, but data were insufficient for network meta-analysis and were not rated with GRADE. AUDIENCE AND PATIENT POPULATION: The audience for this clinical guideline is physicians and other clinicians. The population is nonpregnant adults with type 2 diabetes.

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/m23-2788

Cites

2 of 2 references verified0 citation errors · 0 not checkable

Statistics

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?

  • Clinical research supports the validity of the anti-inflammatory properties of GLP-1 receptor agonists in the therapeutic setting.

    “Clinical research also supports the validity of these antiinflammatory properties in the therapeutic setting.107”

    From The effect of <scp>GLP</scp> ‐1 receptor agonists on circulating inflammatory markers in type 2 diabetes patients: A systematic review and meta‐analysis (2025) · cites this paper as [107]

    The Methods and Recommendations (Recommendation 1; page unavailable) discuss clinical outcomes of GLP-1 agonist treatment, including mortality, cardiovascular events, stroke, and weight loss. They do not address whether those benefits reflect anti-inflammatory properties. Searches for inflammation and anti-inflammatory effects found no passage supporting the attributed claim. (LLM, conf=0.76)

    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.

Cites

Flagged first, then by citations

Research works printed but not linked: 28

  1. [32]Drummond MF, Jefferson TO; The BMJ Economic Evaluation Working Party. Guidelines for authors and peer reviewers of economic submissions to the BMJ. BMJ. 1996; 313: 275– 283. doi: 10.1136/bmj.313.7052.275 8704542 PMC2351717 · DOI · Paper page
  2. [33]Aluko P, Graybill E, Craig D, Economic evidence. In: Higgins J, Thomas J, eds. Cochrane Handbook for Systematic Reviews of Interventions. 2022. Accessed at https://training.cochrane.org/handbook/current/chapter-20 on 8 March 2024.
  3. [35]Bertram MY, Lauer JA, Stenberg K, Methods for the economic evaluation of health care interventions for priority setting in the health system: an update from WHO CHOICE. Int J Health Policy Manag. 2021; 10: 673– 677. doi: 10.34172/ijhpm.2020.244 33619929 PMC9278384 · DOI · Paper page
  4. [36]Nimdet K, Chaiyakunapruk N, Vichansavakul K, A systematic review of studies eliciting willingness-to-pay per quality-adjusted life year: does it justify CE threshold? PLoSOne. 2015; 10: e0122760. doi: 10.1371/journal.pone.0122760 PMC4391853 25855971 · DOI
  5. [1]Stierman B, Afful J, Carroll MD, National Health and Nutrition Examination Survey 2017–March 2020 prepandemic data files development of files and prevalence estimates for selected health outcomes. Natl Health Stat Report. 14 June 2021. doi: 10.15620/cdc:106273 PMC11513744 39380201 · DOI · Paper page
  6. [2]Sun H, Saeedi P, Karuranga S, IDF Diabetes Atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022; 183: 109119. doi: 10.1016/j.diabres.2021.109119 34879977 PMC11057359 · DOI · Paper page
  7. [5]American Diabetes Association. Economic costs of diabetes in the U.S. in 2017. Diabetes Care. 2018; 41: 917– 928. doi: 10.2337/dci18-0007 29567642 PMC5911784 · DOI · Paper page
  8. [6]Liu J, Yi SS, Russo R, Trends and disparities in diabetes and pre-diabetes among adults in the United States, 1999-2018. Public Health. 2023; 214: 163– 170. doi: 10.1016/j.puhe.2022.10.021 36586345 PMC9839558 · DOI
  9. [8]Hill-Briggs F, Adler NE, Berkowitz SA, Social determinants of health and diabetes: a scientific review. Diabetes Care. 2020; 44: 258– 279. doi: 10.2337/dci20-0053 33139407 PMC7783927 · DOI · Paper page
  10. [10]Iyen B, Vinogradova Y, Akyea RK, Ethnic disparities in mortality among overweight or obese adults with newly diagnosed type 2 diabetes: a population-based cohort study. J Endocrinol Invest. 2022; 45: 1011– 1020. doi: 10.1007/s40618-021-01736-9 35025081 PMC8995280 · DOI
  11. [11]Lenzi FR, Filardi T. Social determinants of vulnerabilities in type 2 diabetes: a call to action. J Endocrinol Invest. 2023; 46: 841– 844. doi: 10.1007/s40618-022-01952-x 36318450 · DOI
  12. [12]Corwin T, Ozieh MN, Garacci E, Association of social risk domains with poor cardiovascular risk factor control in US adults with diabetes, from 2006 to 2016. JAMA Netw Open. 2022; 5: e2230853. doi: 10.1001/jamanetworkopen.2022.30853 36083585 PMC9463604 · DOI
  13. [13]American Diabetes Association. Standards of Medical Care in Diabetes–2022 abridged for primary care providers. Clin Diabetes. 2022; 40: 10– 38. doi: 10.2337/cd22-as01 35221470 PMC8865785 · DOI · Paper page
  14. [14]Ogunwole SM, Golden SH. Social determinants of health and structural inequities–root causes of diabetes disparities. Diabetes Care. 2021; 44: 11– 13. doi: 10.2337/dci20-0060 33571949 · DOI
  15. [15]Clark ML, Utz SW. Social determinants of type 2 diabetes and health in the United States. World J Diabetes. 2014; 5: 296– 304. doi: 10.4239/wjd.v5.i3.296 24936251 PMC4058734 · DOI
  16. [16]Mercado C, Beckles G, Cheng Y, Trends and socioeconomic disparities in all-cause mortality among adults with diagnosed diabetes by race/ethnicity: a population-based cohort study - USA, 1997–2015. BMJ Open. 2021; 11: e044158. doi: 10.1136/bmjopen-2020-044158 PMC8098944 33947732 · DOI
  17. [17]Lee W, Lloyd JT, Giuriceo K, Systematic review and meta-analysis of patient race/ethnicity, socioeconomics, and quality for adult type 2 diabetes. Health Serv Res. 2020; 55: 741– 772. doi: 10.1111/1475-6773.13326 32720345 PMC7518886 · DOI
  18. [19]Qaseem A, Barry MJ, Humphrey LL,; Clinical Guidelines Committee of the American College of Physicians. Oral pharmacologic treatment of type 2 diabetes mellitus: a clinical practice guideline update from the American College of Physicians. Ann Intern Med. 2017; 166: 279– 290. doi: 10.7326/M16-1860 28055075 · DOI
  19. [20]Qaseem A, Kansagara D, Lin JS,; Clinical Guidelines Committee of the American College of Physicians. The development of clinical guidelines and guidance statements by the Clinical Guidelines Committee of the American College of Physicians: update of methods. Ann Intern Med. 2019; 170: 863– 870. doi: 10.7326/M18-3290 31181568 · DOI
  20. [21]Qaseem A, Wilt TJ; Clinical Guidelines Committee of the American College of Physicians. Disclosure of interests and management of conflicts of interest in clinical guidelines and guidance statements: methods from the Clinical Guidelines Committee of the American College of Physicians. Ann Intern Med. 2019; 171: 354– 361. doi: 10.7326/M18-3279 31426089 · DOI
  21. [23]Qaseem A, Forland F, Macbeth F,; Board of Trustees of the Guidelines International Network. Guidelines International Network: toward international standards for clinical practice guidelines. Ann Intern Med. 2012; 156: 525– 531. doi: 10.7326/0003-4819-156-7-201204030-00009 22473437 · DOI · Paper page
  22. [24]Drake T, Landsteiner A, Langsetmo L, Newer pharmacologic treatments in adults with type 2 diabetes: a systematic review and network meta-analysis for the American College of Physicians. Ann Intern Med. 2024; 177: 618– 632. doi: 10.7326/M23-1490 38639549 · DOI
  23. [25]Schousboe JT, Landsteiner A, Drake T, Cost-effectiveness of newer pharmacologic treatments in adults with type 2 diabetes: a systematic review of cost-effectiveness studies for a clinical guideline of the American College of Physicians. Ann Intern Med. 2024; 177: 633– 642. doi: 10.7326/M23-1492 38639547 · DOI
  24. [26]Neumann PJ, Kim DD. Cost-effectiveness thresholds used by study authors, 1990-2021. JAMA. 2023; 329: 1312– 1314. doi: 10.1001/jama.2023.1792 37071104 PMC10114019 · DOI
  25. [27]Garrison LP Jr, Neumann PJ, Willke RJ, A health economics approach to US value assessment frameworks–summary and recommendations of the ISPOR Special Task Force Report [7]. Value Health. 2018; 21: 161– 165. doi: 10.1016/j.jval.2017.12.009 29477394 · DOI
  26. [28]Visual Guideline - Newer pharmacologic treatments in adults with type 2 diabetes: a visual clinical guideline from the American College of Physicians. Ann Intern Med. Epub 19 April 2024. doi: 10.7326/M24-0803 38639540 · DOI
  27. [29]Qaseem A, Wilt TJ, Kansagara D,; Clinical Guidelines Committee of the American College of Physicians. Hemoglobin A1c targets for glycemic control with pharmacologic therapy for nonpregnant adults with type 2 diabetes mellitus: a guidance statement update from the American College of Physicians. Ann Intern Med. 2018; 168: 569– 576. doi: 10.7326/M17-0939 29507945 · DOI
  28. [30]Choudhry NK, Denberg TD, Qaseem A; Clinical Guidelines Committee of American College of Physicians. Improving adherence to therapy and clinical outcomes while containing costs: opportunities from the greater use of generic medications: best practice advice from the Clinical Guidelines Committee of the American College of Physicians. Ann Intern Med. 2016; 164: 41– 49. doi: 10.7326/M14-2427 26594818 · DOI

Cited by

Sorted by citations

Authors
Qaseem, A., Obley, A. J., Shamliyan, T., Hicks, L. A., Harrod, C. S., Crandall, C. J., Clinical Guidelines Committee of the American College of Physicians, Balk, E. M., Cooney, T. G., Cross, J. T., Fitterman, N., Lin, J. S., Maroto, M., Miller, M. C., Shekelle, P., Tice, J. A., Tufte, J. E., Etxeandia-Ikobaltzeta, I., Yost, J., Qaseem, A., Obley, A. J., Shamliyan, T., Hicks, L. A., Harrod, C. S., Crandall, C. J., Wilt, T. J., Owens, D. K., Carroll, K., Balk, E. M., Cooney, T. G., Cross, J. T., Fitterman, N., Lin, J. S., Maroto, M., Miller, M. C., Shekelle, P., Tice, J. A., Tufte, J. E., Etxeandia-Ikobaltzeta, I., & Yost, J.
ORCID
Wilt, Timothy J.
Venue
Annals of Internal Medicine
Publisher
American College of Physicians
Published
2024-05
Volume
177
Issue
5
Pages
658-666
ISSN
  • 0003-4819 (ISSN-L)
  • 1539-3704
DOI
10.7326/m23-2788
PMC
PMC11614146
OpenAlex
W4394942565
Cited by
102
References
2
Citations by year
2026: 29 · 2025: 48 · 2024: 25
FWCI
33.59
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)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
American College of Physicians
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, pharmacotherapy, GLP-1 receptor agonists, GIP receptor agonist, SGLT2 inhibitors, DPP-4 inhibitors, long-acting insulin, combination therapy, cardiovascular outcomes, all-cause mortality, congestive heart failure, chronic kidney disease, hypoglycemia, weight loss, comparative effectiveness
MeSH terms
Sodium-Glucose Transporter 2 Inhibitors, Adult, Diabetes Mellitus, Type 2, Drug Therapy, Combination, Humans, Hypoglycemic Agents, Insulin, Glucagon-Like Peptide 1, Dipeptidyl-Peptidase IV Inhibitors

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