Insufficient evidence of benefit for colesevelam in glycemic control in type 2 diabetes

Another drug for type 2

Colesevelam is a bile acid sequestrant drug that was originally approved in the US for the treatment of hyperlipidaemia.  It was subsequently found to help improve glycaemic control in type 2 diabetes.  This dual benefit offers significant potential in reducing the risk of complications in T2.  This Cochrane systematic review set out to summarise all [read the full story…]

Linagliptin rejected by the NHS in Wales for use in type 2 diabetes due to lack of evidence of efficacy

A pen ticking off a checklist

We previously reported systematic reviews of DPP-4 inhibitors.  Recently, the All Wales Medicines Strategy Group, the government agency charged with assessing the effectiveness of medicines and making recommendations about their use in the NHS in Wales, issued an evaluation of linagliptin, a DPP-4 inhibitor marketed under the brand name Trajenta. Clinical question: In patients with [read the full story…]

ACP guidance for treating type 2 diabetes with oral agents

A pen ticking off a checklist

The American College of Physicians has issued updated guidance on managing type 2 diabetes with oral antidiabetic drugs (OADs). The guideline includes a systematic review of the evidence on efficacy regarding various comparisons of monotherapy and combined therapy. Scope: Methods Comparative Effectiveness of Type 2 Diabetes Medications on Intermediate Outcomes Comparative Effectiveness of Type 2 [read the full story…]

Share this post: Share on Facebook Tweet this on Twitter Share on LinkedIn Share on Google+ Share via email

Exenatide is better than placebo in type 2 diabetes not on insulin, at a cost

A syringe

This systematic review analysed all of the placebo-controlled studies of exenatide in the treatment of type 2 diabetes. Clinical question: In type 2 diabetes not on insulin, does exenatide improve glycaemic control, reduce weight or ha The reviewers also looked at adverse events such as  nausea and hypoglycaemia. The evidence: Fourteen articles were found, comprising [read the full story…]

Exenatide improves glycaemic control and body weight but has important side effects

A syringe

Exenatide is an injectable incretin-based drug treatment for type 2 diabetes belonging to the the class of glucagon-like peptide-1 (GLP-1) agonists.  One of its benefits is that it reduces body weight as well as glycaemia. NICE currently recommends exenatide as an add-on therapy where oral agents are not tolerated or ineffective.  This systematic review sought [read the full story…]

Metformin may reduce the risk of cancer, but more research is needed

cancer_blood

This systematic review looked at the relationship between oral antidiabetic drugs and the risk of cancer. Clinical question: In type 2 diabetes, does treatment with metformin or sulphonylurea affect the risk of cancer? The evidence: The reviewers found 17 observational studies reporting 37,632 cases of cancer.  When they pooled the data from these studies they [read the full story…]

No difference between TZDs and DPP-4 inhibitors or sulphonylureas added to metformin in type 2 diabetes

Some pills

Research question: In people with type 2 diabetes inadequately controlled with metformin, which additional oral therapy offers the greatest improvement in HbA1c? The reviewers just looked at glycaemic control in patients whose starting HbA1c was 7% or higher at 12 weeks or longer follow-up. The evidence: Eight randomised trials were found, which looked at various [read the full story…]

Possible adverse effects of DPP-4 inhibitors in type 2 diabetes

Pills

DPP-4 inhibitors, or “gliptins”, are a new oral therapy for type 2 diabetes.  This review set out to find evidence for their safety in long term use. Clinical question: In type 2 diabetes, do DPP-4 inhibitors have any adverse effects? The evidence: The reviewers found 67 randomised controlled trials that evaluated alogliptin, linagliptin, saxagliptin, sitagliptin, [read the full story…]

Limited evidence of better glycaemic control with GLP-1 analogues in type 2 diabetes

A syringe

We recently reported on a review of GLP-1 analogues as a second line of treatment in type 2 diabetes.  A new systematic review reports on a direct comparison with insulin therapy in poorly controlled type 2 diabetes. Clinical question: In type 2 diabetes poorly controlled on oral therapy, do GLP-1 analogues as compared with insulin, [read the full story…]

Limited evidence for GLP-1 analogs as second line treatment for type 2 diabetes

A syringe

There remains considerable uncertainty as to the next step for treatment of type 2 diabetes that has not been successfully controlled using metformin.  A recent systematic review looked at this issue. Clinical question: In type 2 diabetes inadequately controlled on metformin alone, what additional therapy improves glycemic control? The reviewers also looked at potential adverse [read the full story…]