According to study led by researchers from Aldo Moro de Bari University (Italy), all hypoglycemic drugs marketed, and there are many, they have a totally similar safety and efficiency profile.
Specifically, the study, the most exhaustive developed to date in this regard and published in the magazine "Jama", notes that the nine classes of hypoglycemic drugs already available have a very similar efficacy and the same risk of cardiovascular disease and general mortality.A risk, in addition, that is independent of the drug being administered in monotherapy or in combination with other hypoglycemic.
equally insurance and effective
In their review or 'meta -analysis', the authors evaluated the results achieved in more than 300 clinical trials carried out with a total of 120,226 adults with type 2 diabetes to evaluate the safety and effectiveness of the nine classes of hypoglycemic drugs available - including thedifferent types of insulin.
Of the total studies analyzed, 177 were performed with a single hypoglycemic drug in monotherapy - with a total of 56,598 patients–;In 109 the combination of one of the drugs with metformin - dual therapy;53,030 participants–;and in 29 the combination of a hypoglycemic with metformin and a sulfonylurea - trimple therapy was evaluated;10,598 patients.
The results showed the absence of significant differences between the different drugs, whether they were administered in monotherapy, dual therapy or triple therapy, in relation to the risk of cardiovascular disease - how, for example, of the presentation of a myocardial infarction or an stroke -and of mortality for any cause.
Our findings are consistent with the recommendation to use monotherapy metformin as an initial treatment
And in this context, what happened in relation to effectiveness?Was it also similar to all classes of hypoglycemicas evaluated?Well, according to the results, yes.
As the authors indicate, «one of the main findings of our meta -analysis is that despite having more than 300 clinical trials developed with more than 120,000 adults, the evidence that any hypoglycemic drug prolongs life expectancy or prevents cardiovascular diseaseto a greater extent that others are very limited ».
Start with metformin
In short, and according to the results, what drug should be taken, at least as initial therapy?As the authors conclude, the starting treatment of type 2 diabetes must contemplate, as recommended by the American Diabetes Association (ADA), the administration of monotherapy metformin.
As Giovanni F. M. Strippoli, director of the investigation concludes, “metformin was associated with a minimal or non -significant difference in glucosylated hemoglobin levels (HBA1C) when compared to the rest of the drugs of the different classes.In addition, all drugs showed their effectiveness when combined with metformin.Thus, our findings are consistent with the recommendations of the ADA to use metformin in monotherapy as an initial treatment in patients with type 2 diabetes and select additional therapies depending on the specific characteristics of each patient ».