Evidence map›Paper›PMID 42365335›Full record

ArticleDiabetology & metabolic syndrome2026

Comparative cardiovascular efficacy of antidiabetic therapies in type 2 diabetes: a systematic review and network meta-analysis of randomized trials.

Donya Mohammadi, Behnam Sadeghirad, Mohammad Aziz Rasouli, Lotfollah Saed, Hamid Reza Baradaran, Yousef Moradi

Abstract read
In one paragraph

Article in Diabetology & metabolic syndrome, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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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

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

6 authors.

Donya MohammadiSocial Determinant of the Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Behnam SadeghiradDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.
Mohammad Aziz RasouliSocial Determinant of the Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Lotfollah SaedDepartment of Endocrinology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Hamid Reza BaradaranEndocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
Yousef MoradiHealth Metrics and Evaluation Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran. yousefmoradi211@yahoo.com.ORCID http://orcid.org/0000-0002-2936-5930

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality among individuals with type 2 diabetes mellitus (T2DM), imposing a substantial burden on healthcare systems. This systematic review and network meta-analysis evaluated the comparative efficacy of antidiabetic medications and combination therapies in reducing cardiovascular outcomes in patients with T2DM.

methodsPubMed (Medline), Embase, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to December 30, 2024, for randomized controlled trials (RCTs) assessing cardiovascular outcomes in adults with T2DM treated with metformin, sulfonylureas, thiazolidinediones (TZDs), dipeptidyl peptidase‑4 (DPP‑4) inhibitors, glucagon‑like peptide‑1 (GLP‑1) receptor agonists, sodium-glucose cotransporter‑2 (SGLT2) inhibitors, or insulin. Outcomes included cardiovascular mortality, myocardial infarction (MI), stroke, heart failure, hospitalization for cardiovascular events, and unstable angina. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and analyses were conducted with a random-effects model in Stata (version 18).

resultsFrom 10,514 records, 133 RCTs involving 289,558 participants (mean age: 64.7 years) were included. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) significantly reduced cardiovascular mortality (RR = 0.85, 95% CI: 0.75-0.98; high-certainty evidence) and stroke (RR = 0.83, 95% CI: 0.74-0.93; high-certainty evidence). SGLT2 inhibitors significantly reduced heart failure (RR = 0.64, 95% CI: 0.53-0.77; high-certainty evidence) and hospitalization for cardiovascular events (RR = 0.72, 95% CI: 0.68-0.77; high-certainty evidence). An indirect comparison suggested lower cardiovascular mortality with DPP-4 inhibitors versus GLP-1 receptor agonists, although this finding should be interpreted cautiously due to network imbalance.

conclusionsGLP-1 RAs and SGLT2 inhibitors are associated with significant reductions in specific cardiovascular outcomes in patients with T2DM, particularly in reducing cardiovascular mortality, stroke, heart failure, and hospitalization. Treatment decisions should integrate patient-specific risk profiles and cost-effectiveness to optimize outcomes.

Indexed as

Cardiovascular DiseasesEvidence SynthesisPharmacological InterventionsType 2 Diabetes Mellitus

Identifiers

PMID42365335
PMCPMC13573484

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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.