Closing
Does metformin improve glycemic control more than other treatments?
Mostly studied in type 2 & unspecified diabetes. Also asked versus placebo.
Not modeled yetTrial evidence exists, but no mechanistic model yetWithout a model there is no decisive experiment to propose. Help build it. →
Where the evidence stands
A coin flip. So far, the results disagree.
NoUnsureYes
- Belief
- 0.50 (range 0.00–0.55)
- Trials for
- 10
- Trials against
- 10
- Inconclusive
- 5
Already under way
- Generic Drugs (Dapagliflozin and Saxagliptin) Treat Type 2 Diabetes Patients With Controlled CancersNCT07033585 · active not recruiting · started 2026
- A Double-Blind, Randomized, Active-Controlled Phase 2a Trial to Evaluate the Safety, Tolerability, and Preliminary Efficacy of TriGlytza®-01 in Overweight and…NCT07139405 · not yet recruiting · started 2026
- Regimen Transition After Short-Term Intensive Insulin Therapy in Type 2 Diabetes Mellitus Patients With Inadequate Glycemic Control on Oral Hypoglycemic…NCT07173712 · not yet recruiting · started 2026
- Efficacy and Safety of Henagliflozin, Retagliptin, and Metformin Extended-Release Tablets in Chinese Patients With Type 2 Diabetes MellitusNCT07441187 · not yet recruiting · started 2026
- Comparative Efficacy and Safety of Metformin-Empagliflozin-Sitagliptin vs. Metformin-Empagliflozin-Linagliptin as Initial Triple Therapy in Type 2 Diabetes…NCT07452913 · enrolling by invitation · started 2026
The evidence so far
- Registered trials
- 846
- With posted results
- 298
- Published papers
- 112
Of 224 decided analyses: 116 favor metformin, 83 find no difference, 25 favor the comparator.
Papers
- A prospective, parallel group, open-labeled, comparative, multi-centric, active controlled study to evaluate the safety, tolerability and benefits of fixed dose combination of acarbose and metformin versus metformin alone in type 2 diabetes.Trial report · 2010
- Efficacy and safety of enavogliflozin versus dapagliflozin added to metformin plus gemigliptin treatment in patients with type 2 diabetes: A double-blind, randomized, comparator-active study: ENHANCE-D study.Trial report · 2023
- Efficacy and safety of ipragliflozin as an add-on therapy to sitagliptin and metformin in Korean patients with inadequately controlled type 2 diabetes mellitus: A randomized controlled trial.Trial report · 2018
- Rosiglitazone/metformin fixed-dose combination compared with uptitrated metformin alone in type 2 diabetes mellitus: a 24-week, multicenter, randomized, double-blind, parallel-group study.Trial report · 2005
- Initial combination therapy with saxagliptin and metformin provides sustained glycaemic control and is well tolerated for up to 76 weeks.Trial report · 2011
- Add on DPP-4 inhibitor alogliptin alone or in combination with pioglitazone improved β-cell function and insulin sensitivity in metformin treated PCOS.Trial report · 2017
Trials
- The Impact of LY2189265 Versus Metformin on Glycemic Control in Early Type 2 Diabetes Mellitus (AWARD-3: Assessment of Weekly AdministRation of LY2189265 in Diabetes-3)NCT01126580 · 34 posted results
- A Randomized, Parallel Group, Double-blind, Multi-center Study Comparing the Efficacy and Safety of AVANDAMET and Metformin After 80 Weeks of Treatment.NCT00386100 · 12 posted results
- Modulation of Insulin Secretion and Insulin Sensitivity in Bangladeshi Type 2 Diabetic Subjects by an Insulin Sensitizer Pioglitazone and T2DM Association With PPARG Gene Polymorphism.NCT01589445 · 7 posted results
- A 24-Week, Randomised, Double-Blind, Active-Controlled, Multi-Centre Phase IIIb/IV Study to Evaluate the Efficacy and Tolerability of Saxagliptin Add-On Compared to Uptitration of Metformin in Patients With Type 2 Diabetes Mellitus With Inadequate Glycaemic Control on Sub-Maximal Doses of MetforminNCT01006590 · 6 posted results
- Glycemic Control in Children and Adolescents With Double Diabetes: Trial of Optimized Insulin-Metformin RegimenNCT01334125 · 3 posted results
- Safety and Efficacy of Exenatide Once Weekly Injection Versus Metformin, Dipeptidyl Peptidase-4 Inhibitor, or Thiazolidinedione as Monotherapy in Drug-Naive Patients With Type 2 DiabetesNCT00676338 · 11 posted results
- Beta Cell Restoration Through Fat MitigationNCT01763346 · 3 posted results
- A Multicenter, Randomized, Double-Blind, Placebo-Controlled Study to Determine the Efficacy and Safety of Alogliptin and Metformin Fixed Dose Combination, Alogliptin Alone, or Metformin Alone in Subjects With Type 2 Diabetes MellitusNCT01890122 · 14 posted results