title: [Role of metformin in diabetes treatment--is metformin falling from grace?].
abstract: Two recent meta-analyses focused on the risk-benefit ratio of metformin in the treatment of type 2 diabetes mellitus. Both studies conclude that the risk-benefit ratio of metformin monotherapy or combined with insulin is uncertain. In our opinion, the interpretation of the known literature in these meta-analyses could be flawed. To ascertain the effects of metformin on cardiovascular end-points, a follow-up period of at least 8 years proved necessary. However, these meta-analyses included a number of studies with a limited follow-up period, thus impairing the possibility to make a proper comparison of the long-term effects of metformin. In addition, one meta-analysis based the weight of included studies on the number of events in all studies, including two safety studies, as opposed to the number of studied patients.
authors.affiliation: Isala klinieken, Diabetes Centrum, Zwolle, the Netherlands. p.r.van.dijk@isala.nl
authors.forename: Peter R
authors.initials: PR
authors.lastname: van Dijk
authors.forename: Gijs W D
authors.initials: GW
authors.lastname: Landman
authors.forename: Henk J G
authors.initials: HJ
authors.lastname: Bilo
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use; D008687:Metformin / Q000009:adverse effects / Q000627:therapeutic use*; D061214:Patient Safety; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin