| Abstract: |
This fact sheet compares the effectiveness and safety of oral diabetes medications for adults with type 2 diabetes. The author notes that as new classes of medications have become available, clinicians and patients have faced an array of oral medications with different mechanisms of action. The fact sheet explores how oral diabetes medications for the treatment of adults with type 2 diabetes differ in their ability to affect the following proximal clinical outcomes: glycated hemoglobin, weight, blood pressure, serum lipid levels, and 2-hour postprandial glucose (PPG) levels; considers how these medications differ in their ability to affect distal diabetes-related complications, including mortality, coronary artery disease, myocardial infarction, stroke, transient ischemic attack, arrhythmia, coronary artery stenosis and in-stent restenosis, retinopathy, nephropathy, neuropathy, and peripheral arterial disease (PAD); discusses the impact of these medications on other health outcomes, including quality of life and functional status; reviews the life-threatening and less serious adverse events that are associated with each of these medications; and considers whether the safety and effectiveness of these medications vary across particular adult populations such as those based on demographic factors or comorbid conditions. Specific drugs discussed are thiazolidinediones, second-generation sulfonylureas, metformin, repaglinide, acarbose, rosiglitazone, alpha-glucosidase inhibitors, pioglitazone, and glyburide. A summary table presents the main conclusions from published evidence regarding the comparative effectiveness of oral diabetes medications, organized by key question and type of outcome. A second table presents a summary of the comparative effectiveness of the oral diabetes medications. The fact sheet is from a series called the Effective Health Care Program, established to provide valid evidence about the comparative effectiveness of different medical interventions. The goal is to help consumers, health care providers, and others in making informed choices among treatment alternatives. 2 tables. |