Prescrire international
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Prescrire international · May 2015
ReviewGlucose-lowering treatment of type 2 diabetes. Part II--Glucose-lowering drugs after metformin: a choice based largely on adverse effects.
Metformin alone is the glucose-lowering drug of first choice for patients with type 2 diabetes. None of the other glucose-lowering drugs available in 2014 have any proven efficacy in preventing diabetes complications. How important are adverse effects in the choice of glucose-lowering alternatives to metformin for patients with type 2 diabetes? What about their effects on HbA1c levels? To answer these questions, we conducted a review of the literature using the standard Prescrire methodology. ⋯ These drugs are already known to have a burdensome adverse effect profile despite their relatively recent market introduction. There are also safety signals concerning serious long-term adverse effects. Patients should not be exposed to these risks.