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Comparative efficacy of glimepiride and metformin in monotherapy of type 2 diabetes mellitus: Meta-analysis of randomized controlled trials
Zhu H.2; Zhu S.2; Zhang X.2; Guo Y.2; Shi Y.2; Chen Z.2; Leung S.-W.2
2013-11-18
Source PublicationDiabetology and Metabolic Syndrome
ISSN17585996
Volume5Issue:1
AbstractBackground: Metformin treatment has been the most recommended monotherapy of type 2 diabetes mellitus (T2DM) for decades but is challenged by new antidiabetic drugs. This study conducted a meta-analysis of randomized controlled trials (RCT) comparing the efficacy of metformin and glimepiride in monotherapy of T2DM. Methods. A literature search for RCTs on glimepiride and metformin was conducted on the bibliographic databases, including PubMed, Cochrane Library and ScienceDirect, from their inceptions to 25 Mar 2013. All RCTs were selected according to pre-specified eligibility criteria. The quality of articles was assessed with the Cochrane's risk of bias tool. Statistical meta-analysis evaluated the overall effects and biochemical indices of T2DM. Sensitivity and subgroup analyses evaluated the robustness and explained the heterogeneity of the results. Begg and Egger's tests quantified possible publication biases. Results were represented as "standard mean difference or odds ratio [95% confidence internals] P value". Results: Fifteen RCTs with 1681 adult T2DM patients were included for meta-analysis. Metformin was not better than glimepiride in overall efficacy in controlling the levels of HbA1c, postprandial blood sugar (PPBS), fasting plasma insulin (FINS), systolic and diastolic blood pressures (SBP and DBP), and high density lipoprotein (HDL). Metformin was only more effective than glimepiride in controlling the levels of total cholesterol (TC, 0.33 [0.03, 0.63], P = 0.03), low-density lipoprotein (LDL, 0.35 [0.16, 0.53], P = 0.0002) and triglycerides (TG, 0.26 [0.05, 0.46], P = 0.01). Odds ratios of adverse events showed that glimepiride was more likely to induce hypoglycemia episodes and metformin was with a higher risk of gastrointestinal upset. Conclusion: Metformin was not significantly better than glimepiride in glycemic control of T2DM, suggesting that glimepiride would be a good choice second to metformin in the monotherapy of T2DM. © 2013 Zhu et al.; licensee BioMed Central Ltd.
KeywordGlimepiride Meta-analysis Metformin Type 2 diabetes mellitus
DOI10.1186/1758-5996-5-70
URLView the original
Language英語
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Cited Times [WOS]:4   [WOS Record]     [Related Records in WOS]
Document TypeJournal article
CollectionInstitute of Chinese Medical Sciences
Affiliation1.University of Edinburgh
2.Universidade de Macau
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GB/T 7714
Zhu H.,Zhu S.,Zhang X.,et al. Comparative efficacy of glimepiride and metformin in monotherapy of type 2 diabetes mellitus: Meta-analysis of randomized controlled trials[J]. Diabetology and Metabolic Syndrome,2013,5(1).
APA Zhu H..,Zhu S..,Zhang X..,Guo Y..,Shi Y..,...&Leung S.-W..(2013).Comparative efficacy of glimepiride and metformin in monotherapy of type 2 diabetes mellitus: Meta-analysis of randomized controlled trials.Diabetology and Metabolic Syndrome,5(1).
MLA Zhu H.,et al."Comparative efficacy of glimepiride and metformin in monotherapy of type 2 diabetes mellitus: Meta-analysis of randomized controlled trials".Diabetology and Metabolic Syndrome 5.1(2013).
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