Evidence map›Paper›PMID 41084648›Full record

ReviewCureus2025

Insulin Versus Established GLP-1 Receptor Agonists, DPP-4 Inhibitors, and SGLT-2 Inhibitors for Uncontrolled Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Ammar Ahmed, Zi Tan, Waddah Abd El-Radi, Krishnakumar Rajamani

Abstract readReview
In one paragraph

Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Antidiabetic Properties ofLife (Basel, Switzerland) · 2026
    Review
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

4 authors.

Ammar AhmedDepartment of Medicine, University of Minnesota School of Medicine, Minneapolis, USA.
Zi TanDepartment of Endocrinology, Medical University of South Carolina (MUSC) Health Endocrinology at Nexton Medical Park, Summerville, USA.
Waddah Abd El-RadiDepartment of Internal Medicine, Rochester Regional Health, Rochester, USA.
Krishnakumar RajamaniDepartment of Medicine/Diabetes Endocrinology and Metabolism, Rochester Regional Health, Rochester, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Limited head-to-head studies compare established glucagon-like peptide-1 receptor agonists (GLP-1 RAs), dipeptidyl peptidase-4 inhibitors (DPP-4is), and sodium-glucose co-transporter-2 inhibitors (SGLT-2is) to insulin in the management of uncontrolled type 2 diabetes mellitus (T2DM). This systematic review and meta-analysis evaluated the efficacy and safety of traditional GLP-1 RAs, DPP-4is, and SGLT-2is compared with insulin. Comprehensive searches were conducted in the Cochrane Database, PubMed, MEDLINE, ClinicalTrials.gov, and EMBASE for publications from January 2010 to June 2022, with an additional search extended through June 2025 to capture newly published studies. Randomized controlled trials (RCTs) comparing insulin with established GLP-1 RAs, DPP-4is, or SGLT-2is were included. Thirteen trials involving 5,807 participants were identified. Nine trials compared GLP-1 RAs to insulin, four compared DPP-4is to insulin, and one examined SGLT-2i combined with DPP-4i versus insulin. Compared with insulin, traditional non-insulin agents were associated with greater reductions in hemoglobin A1c (HbA1c) (mean difference (MD) = -0.27, 95% confidence interval (CI) -0.5 to -0.03), body weight (MD = -3.27, 95% CI -4.16 to -2.38), and systolic blood pressure (MD = -3.55, 95% CI -4.92 to -2.17). Insulin use carried a higher relative risk of hypoglycemia (risk ratio (RR) = 2.24, 95% CI 1.88-2.67). Subgroup analyses showed that GLP-1 RAs were superior to insulin in reducing HbA1c and hypoglycemic events, whereas DPP-4is achieved similar glycemic control with improved safety profiles. These findings suggest that established GLP-1 RAs, DPP-4is, and SGLT-2is offer superior or comparable efficacy with better safety than insulin in insulin-naïve patients with uncontrolled T2DM.

Indexed as

dpp-4 inhibitorsglp-1 receptor agonistsinsulinmeta-analysisnon-insulin diabetes medicationssglt-2 inhibitorssystematic reviewtype 2 diabetes mellitus

Identifiers

PMID41084648
PMCPMC12515520

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.