Evidence map›Paper›PMID 32377525›Full record

ArticleJournal of diabetes research2020

Metformin Treatment Is Associated with a Decreased Risk of Nonproliferative Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus: A Population-Based Cohort Study.

Yu-Pei Fan, Chien-Tung Wu, Jiun-Lu Lin, Chao A Hsiung, Hsiao Yu Liu, Jung-Nien Lai, Chen-Chang Yang

Open access · goldFull text read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of diabetes research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed
2.4field-weighted citation impact, top 10% 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.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · 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.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 36 citations in OpenAlex.

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  16. Advanced Glycation End-Products and Diabetic Neuropathy of the Retina.International journal of molecular sciences · 2023
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4 · The record

Corrections and comments

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

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Yu-Pei FanInstitute of Public Health, National Yang-Ming University, Taipei, Taiwan.
Chien-Tung WuInstitute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.ORCID https://orcid.org/0000-0001-6739-9456
Jiun-Lu LinDivision of Endocrinology and Metabolism, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.
Chao A HsiungInstitute of Population Health Sciences, National Health Research Institutes, Taiwan.
Hsiao Yu LiuInstitute of Population Health Sciences, National Health Research Institutes, Taiwan.
Jung-Nien LaiSchool of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.ORCID https://orcid.org/0000-0002-9548-4938
Chen-Chang YangInstitute of Public Health, National Yang-Ming University, Taipei, Taiwan.ORCID https://orcid.org/0000-0003-1391-8323
National Yang Ming Chiao Tung University · TWNational Health Research Institutes · TWChina Medical University · TWMackay Memorial Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo assess the relationship between metformin use and the severity of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM) and to investigate the effect of metformin dosage on reducing the incidence of DR.

methodsThe study population included patients with newly diagnosed T2DM, who were aged ≥20 years and prescribed with antidiabetic drug therapy lasting ≥90 days, as identified using the National Health Insurance Research Database between 2000 and 2012. We matched metformin users and nonusers by a propensity score. Cox proportional hazard regression analyses were used to compute and compare the risk of developing nonproliferative diabetic retinopathy (NPDR) in metformin users and nonusers.

resultsOverall, 10,044 T2DM patients were enrolled. Metformin treatment was associated with a lower risk of NPDR (aHR 0.76, 95% CI 0.68-0.87) and sight-threatening diabetic retinopathy (STDR, aHR 0.29, 95% CI 0.19-0.45); however, the reduction in risk was borderline significant for STDR progression among NPDR patients (aHR 0.54, 95% CI 0.28-1.01). Combination therapy of metformin and DPP-4i exhibited a stronger but inverse relationship with NPDR development (aHR 0.32, 95% CI 0.25-0.41), especially at early (<3 months) stages of metformin prescription. These inverse relationships were also evident at different metformin doses and in adapted Diabetes Complications Severity Index scores (aDCSI). Moreover, combination therapy of metformin with sulfonylureas was associated with an increased risk of NPDR.

conclusionMetformin treatment in patients with T2DM was associated with a reduced risk of NPDR, and a potential trend was found for a reduced STDR risk in patients who had previously been diagnosed with NPDR. Combining metformin with DPP-4i seemingly had a significantly beneficial effect against NPDR risk, particularly when aDCSI scores were low, and when metformin was prescribed early after T2DM diagnosis. These results may recommend metformin for early treatment of T2DM.

Indexed as

AdultAgedCohort StudiesDiabetes Mellitus, Type 2Diabetic RetinopathyDisease ProgressionFemaleHumansHypoglycemic AgentsIncidenceMaleMetforminMiddle AgedHypoglycemic AgentsMetformin

Identifiers

PMID32377525
PMCPMC7189314
OpenAlexW3016946599

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Registered trials

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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.