SynthesisEndocrine2013

The effects of sulfonylureas plus metformin on lipids, blood pressure, and adverse events in type 2 diabetes: a meta-analysis of randomized controlled trials.

Fan Zhang, Hao Xiang, Yunzhou Fan, Tsend-Ayush Ganchuluun, Wenhua Kong, Qian Ouyang, Jingwen Sun, Beibei Cao, Hongbo Jiang, Shaofa Nie

Abstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Endocrine, 2013. The graph read 3 numbers from its abstract, feeding 2 cells of the map, but none could be read as for or against, so it casts no vote. Cited by 7 papers, 1 of them a synthesis that pooled it.

3numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

Read, but not usablea number the graph found but could not read as for or against

Hypoglycaemiacomparator not stated · hypertension, t2dfeeds 2 cells of the map
RR 1.271.03 to 1.57
Hypoglycemia and nervous system side events were more frequent among patients treated with sulfonylureas plus metformin than metformin alone (RR = 6.79, 95 % CI 3.79-12.17; RR = 1.27, 95 % CI 1.03-1.57; respectively), but less in digestive symptoms (RR = 0.75, 95 % CI 0.67-0.84).
Hypoglycaemiacomparator not stated · hypertension, t2dfeeds 2 cells of the map
RR 0.750.67 to 0.84
Hypoglycemia and nervous system side events were more frequent among patients treated with sulfonylureas plus metformin than metformin alone (RR = 6.79, 95 % CI 3.79-12.17; RR = 1.27, 95 % CI 1.03-1.57; respectively), but less in digestive symptoms (RR = 0.75, 95 % CI 0.67-0.84).
Hypoglycaemiacomparator not stated · hypertension, t2dfeeds 2 cells of the map
RR 6.793.79 to 12.2
Hypoglycemia and nervous system side events were more frequent among patients treated with sulfonylureas plus metformin than metformin alone (RR = 6.79, 95 % CI 3.79-12.17; RR = 1.27, 95 % CI 1.03-1.57; respectively), but less in digestive symptoms (RR = 0.75, 95 % CI 0.67-0.84).

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Metformin×hypoglycaemia

No readable resultOpen on the map →What to test next →

1 readable study in this cell: 0 favour the treatment, 1 find no difference, 0 favour the comparator.

Belief with this paper
0.25no deciding trial · 0 families support, 0 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
NCT02980276535 enrolled · 2017
Δ 0.70-5.10 to 6.60

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

Sulfonylureas & glinides×hypoglycaemia

No readable resultOpen on the map →What to test next →

10 readable studies in this cell: 0 favour the treatment, 1 find no difference, 9 favour the comparator.

Belief with this paper
0.50one trial · 1 family supports, 0 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the comparatorfavours the treatment →
0 · no effect
NCT017093055,570 enrolled · 2012
Estimate -8.40-11.1 to -6.10
NCT006609071,217 enrolled · 2008
Δ -37.2-42.3 to -32.2
NCT03332771954 enrolled · 2017
Δ -15.4-19.7 to -11.1
NCT02471404939 enrolled · 2015
Δ -4.21-6.45 to -1.97
NCT00575588891 enrolled · 2007
Δ -33.2-38.1 to -28.5
NCT01682759751 enrolled · 2012
Δ -21.3-26.5 to -16.4
NCT00792935143 enrolled · 2009
Proportions -7.70-23.6 to 8.70

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.

  1. Guideline
  2. Trial
  3. Effect of combined gliclazide/metformin treatment on oxidative stress, lipid profile, and hepatorenal functions in type 2 diabetic patients.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2018
    Article
  4. Review
  5. Review
  6. Article
  7. Article
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Fan ZhangDepartment of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China.
Hao Xiang
Yunzhou Fan
Tsend-Ayush Ganchuluun
Wenhua Kong
Qian Ouyang
Jingwen Sun
Beibei Cao
Hongbo Jiang
Shaofa Nie
Huazhong University of Science and Technology · CNWuhan Business University · CN

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

To compare the effects of sulfonylureas and metformin versus metformin on lipid profiles, blood pressure, and adverse events. PubMed, EMbase, Chinese BioMedical Literature on disc, China National Knowledge Infrastructure, VIP database, and Wanfang database were searched for randomized controlled trials (RCTs), from inception to August 2012. Key outcomes were low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), total cholesterol (TC), blood pressure (BP), hemoglobin A1c (HbA1c), fasting insulin, and adverse events. Twenty RCTs were included in the analysis. Compared to metformin, the combination therapy of sulfonylureas and metformin slightly reduced HDL-C [-0.03, 95 % CI (-0.06, -0.01)] and HbA1c (-0.79, 95 % CI -0.96 to -0.63). However, it showed little effects on LDL-C, TG, TC, and BP. Glipizide plus metformin significantly increased fasting insulin [2.33, 95 % CI (1.94, 2.73)]. Hypoglycemia and nervous system side events were more frequent among patients treated with sulfonylureas plus metformin than metformin alone (RR = 6.79, 95 % CI 3.79-12.17; RR = 1.27, 95 % CI 1.03-1.57; respectively), but less in digestive symptoms (RR = 0.75, 95 % CI 0.67-0.84). Combination therapy with sulfonylureas and metformin may be more effective than metformin alone in improving HbA1c and reducing gastrointestinal reactions. But it had disadvantage of decreasing HDL-C, increasing the risk of hypoglycemia and nervous system side events.

Indexed as

Blood PressureDiabetes Mellitus, Type 2Drug Therapy, CombinationHumansHypoglycemic AgentsLipidsMetforminRandomized Controlled Trials as TopicSulfonylurea CompoundsHypoglycemic AgentsLipidsMetforminSulfonylurea Compounds

Identifiers

PMID23657947
OpenAlexW2037882075

What OpenQuestion holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.