Proportion of patients at HbA1c target <7% with eight classes of antidiabetic drugs in type 2 diabetes: systematic review of 218 randomized controlled trials with 78 945 patients

摘要: Aim We assessed the efficacy of eight classes diabetes medications used in current clinical practice [metformin, sulphonylureas, α-glucosidase inhibitors, thiazolidinediones, glinides, dipeptidyl peptidase-4 glucagon-like peptide-1 (GLP-1) analogues and insulin analogues] to reach HbA1c target Methods MEDLINE, EMBASE Cochrane CENTRAL were searched from inception through April 2011 for randomized controlled trials (RCTs) involving antidiabetic drugs. RCTs had report effect any medication on levels, include at least 30 subjects every arm study, therapy after a minimum 12 weeks. Data summarized across studies using random-effects meta-regression. Results A total 218 (339 arms 77 950 patients) met inclusion criteria. The proportion patients who achieved goal ranged 25.9% (95% CI 18.5-34.9) with inhibitors 63.2% (54.1-71.5) long-acting GLP-1 analogue. There was progressive decrease each 0.5% increase baseline HbA1c, ranging 57.8% ≤7.5% 20.8% ≥10% (p trend 9.0% no further decrease, whereas non-insulin drugs relationship continuous without evidence plateau. Conclusions is considerable variability regard attainment