Review: Insulin monotherapy and insulin combined with oral hypoglycemic agents provide similar glycemic control

摘要

ACP Journal Club. 2005 May-Jun;142:62.nGoudswaard AN, Furlong NJ, Rutten GE, Stolk RP, Valk GD. Insulin monotherapy versus combinations of insulin with oral hypoglycaemic agents in patients with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2004;(4):CD003418. [PubMed ID: 15495054] nnQuestionnnIn patients with type 2 diabetes mellitus and inadequate glycemic control, how do insulin monotherapy and insulin combined with oral hypoglycemic agents (OHAs) compare? nnMethodsnnData sources: 5 databases.nnStudy selection and assessment: Randomized controlled trials (RCTs) with 2-month follow-up that compared insulin monotherapy with combinations of insulin and single or multiple OHAs in patients with type 2 diabetes and inadequate glycemic control. Study quality was assessed using the Maastricht–Amsterdam Criteria List, which considered randomization procedure, allocation concealment, blinding, withdrawals and dropouts, and intention-to-treat analysis (total score range 0 to 7).nnOutcomes: Main outcomes were any diabetes-related morbidity (myocardial infarction, angina, heart failure, stroke, renal failure, amputation, vitreous hemorrhage, retinal photocoagulation, blindness in 1 eye, or cataract extraction) and glycemic control. Additional outcomes included hypoglycemia, insulin requirement, and weight gain.