WEDNESDAY, May 18 (HealthDay News) -- There are no significant differences between the class of antihyperglycemic agents given to patients with uncontrolled type 2 diabetes who are already treated with metformin and a sulfonylurea, according to a meta-analysis published in the May 17 issue of the Annals of Internal Medicine.
Jorge L. Gross, M.D., Ph.D., from the Universidade Federal do Rio Grande do Sul in Porto Alegre, Brazil, and colleagues compared the effects of adding a third antihyperglycemic drug to patients with uncontrolled type 2 diabetes treated with a sulfonylurea and metformin. A total of 18 randomized trials lasting at least 24 weeks were included in the analysis. The trials included a total of 4,535 participants, aged 18 years and older, with type 2 diabetes and hemoglobin A1c (HbA1c) levels higher than 7 percent. Each participant received a third antihyperglycemic drug. The primary end points were changes in HbA1c levels, weight change, and severe hypoglycemia frequency.
The investigators found that the different drug classes used did not differ in their effect on HbA1c levels compared to placebo. An increase in weight was observed with insulin (2.84 kg) and thiazolidinediones (4.25 kg), and a decrease was seen with the use of glucagon-like peptide-1 agonists (1.63 kg). Double the number of severe hypoglycemic episodes was seen with insulin treatment compared to noninsulin antihyperglycemic agents.
"There is no apparent difference in benefit between drug classes in patients with type 2 diabetes who are receiving metformin and a sulfonylurea and require a third antihyperglycemic agent," the authors write.
One of the study authors disclosed financial ties with the pharmaceutical industry.
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