ArticleDiabetes research and clinical practice2015
Comparative effectiveness of early versus delayed metformin in the treatment of type 2 diabetes.
Article in Diabetes research and clinical practice, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 16 citations in OpenAlex.
- Metformin modulates alveolar bone parameters and gene expression in streptozotocin-induced type 2 diabetic rats.BMC oral health · 2026Article
- Therapeutic Inertia in an Insured Population with Type 2 Diabetes in the United States: A Retrospective Cohort Study.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025Article
- Overcoming therapeutic inertia in newly diagnosed type 2 diabetes: Protocol of a randomized, quality improvement trial.Contemporary clinical trials · 2025Article
- The substantial burden of non-communicable diseases and HIV-comorbidity amongst adults: Screening results from an integrated HIV testing services clinic for adults in Soweto, South Africa.EClinicalMedicine · 2021Article
- Risk of incident dementia following metformin initiation compared with noninitiation or delay of antidiabetic medication therapy.Pharmacoepidemiology and drug safety · 2020Article
- Delays in Insulin Initiation among Patients with Type 2 Diabetes Mellitus in Southeast China: A Retrospective, Real-World Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2020Article
- High prevalence and heterogeneity of Dysglycemia in patients with tuberculosis from Peru: a prospective cohort study.BMC infectious diseases · 2019Article
- Factors Associated with Diabetes-Related Clinical Inertia in a Managed Care Population and Its Effect on Hemoglobin A1c Goal Attainment: A Claims-Based Analysis.Journal of managed care & specialty pharmacy · 2019Article
- Gaps and barriers in the control of blood glucose in people with type 2 diabetes.Diabetes & vascular disease research · 2017Review
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
aimThe purpose of this study was to evaluate the effectiveness of early versus delayed initiation of metformin in type 2 diabetes.
methodsWe identified 2925 new users of metformin with type 2 diabetes between 2005 and 2012 in the electronic health records of an integrated health system in Northern California. Patients were matched 1:1 on the propensity for receiving early treatment (defined as ≤6 months from first evidence of diabetes). We evaluated the effectiveness of early versus delayed metformin treatment on intermediate clinical outcomes indicated by changes in hemoglobin A1c (HbA1c) and body mass index (BMI), as well as the incidence of therapy intensification (addition or substitution of a second antihyperglycemic agent).
resultsA total of 2144 propensity-score matched patients were included in the early or delayed treatment group (n=1072, in each). Early treatment was associated with significantly larger decreases in HbA1c (-0.36%; 95% confidence intervals [CI]: -0.44 to -0.27%; P<0.001) and BMI (-0.46 kg/m(2); 95% CI: -0.64 to -0.29 kg/m(2); P<0.001) relative to delayed treatment. Patients receiving early treatment also had a greater likelihood of attaining an HbA1c<7% (<53 mmol/mol) (odds ratio: 2.00; 95% CI: 1.63-2.45; P<0.001) and a reduced risk of therapy intensification (hazard ratio: 0.72; 95% CI: 0.61-0.85; P<0.001).
conclusionsTreatment with metformin earlier in the course of type 2 diabetes is associated with better glycemic control, more pronounced weight reduction, and a lower risk for therapy intensification than delayed treatment. Antihyperglycemic therapy should be initiated early after diagnosis to achieve optimal outcomes.
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