Cochrane · systematic review · CD009008
Sulphonylurea monotherapy for patients with type 2 diabetes mellitus
Hemmingsen Bianca, Schroll Jeppe B, Lund Søren S, et al. · Cochrane Database of Systematic Reviews · 2013 · Cochrane Library
Metabolic and Endocrine DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
12
No studies
9
Included studies
NR
No studies 9 · 42.9%Ungraded 0 · 0%Very low 1 · 4.8%Low 11 · 52.4%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings (first‐generation sulphonylureas)
Population: participants with type 2 diabetes mellitus
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality a. Intervention vs placebo [30 weeks to 4.75 years] b. Intervention vs insulin [4.75 years to 10.0 years] | RR 1.46 [0.87, 2.45] | 2 studies · 553 participants | Low Downgraded: imprecision |
Cardiovascular mortality a. Intervention vs placebo [30 weeks to 4.75 years] b. Intervention vs insulin [4.75 years to 10.0 years] | RR 2.63 [1.32, 5.22] | 2 studies · 553 participants | Low Downgraded: imprecision |
Non‐fatal macrovascular outcomes 1. Composite 2. Non‐fatal myocardial infarction Intervention vs insulin [4.75 years to 10.0 years] | RR 1.08 [0.81, 1.45] | 1 study · 2 participants | Low Downgraded: imprecision |
Microvascular outcomes | no estimate extracted | NR | No studies |
Cancer Intervention vs insulin [4.75 years to 10.0 years] | RR 0.81 [0.29, 2.27] | 2 studies · 1944 participants | Low Downgraded: imprecision |
Adverse events 1. All adverse events 2. Drop‐outs due to adverse events Intervention vs alpha‐glucosidase inhibitors [30 weeks] | RR 0.63 [0.52, 0.76] | 1 study · 2 participants | Low Downgraded: imprecision |
Health‐related quality of life | no estimate extracted | NR | No studies |
Summary of findings (second‐generation sulphonylureas)
Population: participants with type 2 diabetes mellitus
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality a. Intervention vs metformin [a. 24 weeks to 4 years] b. Intervention vs thiazolidinediones [b. 24 weeks to 4 years] c. Intervention vs insulin [c. 9 months to 10 years] d. Intervention vs incretin‐based control [d. 52 weeks to... | RR 0.98 [0.61, 1.58] | 6 studies · 3528 participants | Low Downgraded: imprecision |
Cardiovascular mortality a. Intervention vs metformin [a. 24 weeks to 4 years] b. Intervention vs thiazolidinediones [b. 24 weeks to 4 years] c. Intervention vs insulin [c. 9 months to 10 years] d. Intervention vs meglitinide [d. 12 months to 17 m... | RR 1.47 [0.54, 4.01] | 6 studies · 3528 participants | Low Downgraded: imprecision |
Non‐fatal macrovascular outcomes 1. Composite a. Intervention vs metformin [1a. 6 months to 4 years] b. Intervention vs thiazolidinediones [1b. 52 weeks to 4 years] c. Intervention vs meglitinide [1c. 12 months to 15 months]2. Non‐fatal myocardial... | RR 0.67 [0.48, 0.93] | 1 study · 3 participants | Low Downgraded: imprecision |
Microvascular outcomes | no estimate extracted | NR | No studies |
Adverse events 1. All adverse events 2. Drop‐outs due to adverse events 3. Severe hypoglycaemia a. Intervention vs placebo [1a. 24 weeks] [2a. 24 weeks to 56 weeks] b. Intervention vs metformin [1b. 6 months to 4 years] [2b. 24 weeks to 4 years] [... | RR 0.91 [0.51, 1.62] | 1 study · 2 participants | Low Downgraded: imprecision |
Cancer a. Intervention vs thiazolidinediones [52 weeks to 4 years] b. Intervention vs insulin [6 years to 10 years] | RR 1.02 [0.72, 1.45] | 6 studies · 4192 participants | Low Downgraded: imprecision |
Health‐related quality of life a. Intervention vs thiazolidinediones [12 months] b. Intervention vs insulin [6 years] c. Intervention vs alpha‐glucosidase inhibitors [12 months] | no estimate extracted | 1 study · 35 participants | Very low Downgraded: risk of bias, imprecision |
Summary of findings (third‐generation sulphonylureas)
Population: participants with type 2 diabetes mellitus
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality | no estimate extracted | NR | No studies |
Cardiovascular mortality | no estimate extracted | NR | No studies |
Macrovascular outcomes | no estimate extracted | NR | No studies |
Microvascular outcomes | no estimate extracted | NR | No studies |
Adverse events 1. All adverse events 2. Drop‐outs due to adverse events Interventions vs thiazolidinediones [1. 6 months to 12 months] [2. 24 weeks to 52 weeks] | RR 0.88 [0.78, 0.99] | 1 study · 3 participants | Low Downgraded: imprecision |
Cancer | no estimate extracted | NR | No studies |
Health‐related quality of life | no estimate extracted | NR | No studies |