Lack of evidence to choose second line drug treatments for type 2 diabetes


For people with type 2 diabetes, metformin is the usual choice for first-line drug treatment.  However, there remains some uncertainty as to the best choice for second-line treatments if metformin alone fails to achieve adequate glycaemic control.  This systematic review set out to find out which is the most effective choice. The reviewers conducted a [read the full story…]

Early initiation of insulin glargine may have benefits in type 2 diabetes.

Picture of a syringe

What should be the next step when metformin alone is not enough to control type 2 diabetes?  Current practice usually augments metformin with sulphonylurea. This systematic review addresses the question of whether insulin should be added earlier than is currently the case. The reviewers pooled the data from 11 randomised trials looking at this issue.  [read the full story…]

Systematic review: GLP-1 analogs improve glycemic control in type 2 diabetes

A pancreas

Glucagon-like peptide (GLP-1) analogues, such as exenatide and liraglutide, are drugs that promote the action of insulin in the body and help people with type 2 diabetes control their blood sugar levels. This new systematic review collates all of the evidence about the effectiveness of this type of drug compared with other possible treatments.  This [read the full story…]

In type 2 diabetes, sulphonylureas are the most cost-effective second-line treatment.


Metformin is often the first line of drug treatment for type 2 diabetes.  There is a range of options for additional treatment, should metformin alone prove insufficient to achieve adequate glyaemic control. This economic evaluation looked at the evidence on the effectiveness of these treatment options, balanced against the cost of each. They did this [read the full story…]

In type 2 diabetes, use of metformin was associated with lower incidence of colorectal cancer.

The chemical structure of metformin

Laboratory research has suggested that metformin may inhibit cancer cell growth.  If it does, we would expect people treated with metformin to have a lower rate of cancer. This systematic review combined the data from five observational studies of patients with type 2 diabetes and studied the relationship between their use of metformin and incidence [read the full story…]

Quality of life in people hospitalised with type 2 diabetes

A hand holding a pen filling in a questionnaire

A survey has reported quality of life of data from a cohort of hospitalis patients with type 2 diabetes on either oral antidiabetic agents or insulin regimens. The study used a questionnaire-based instrument – WHOWOL-BREF – to measure quality of life.  The participants had at least 5 years duration of diagnosis and had been hospitalised [read the full story…]

Type 2 diabetes was associated with an increased risk of dementia

Image of a person's head with a jigsaw piece removed

This observational study recruited over 120,000 patients using the Taiwanese National Health Insurance Database and followed them over 7 years to study the incidence of diabetes and dementia. They found that people with untreated type 2 diabetes had over double the incidence of dementia during the study compared with people without diabetes.  People whose diabetes [read the full story…]