title: Effects of pharmacological treatments on micro- and macrovascular complications of type 2 diabetes: what is the level of evidence?
abstract: Antidiabetic drugs for type 2 diabetes receive marketing authorization if they show efficacy in reducing levels of HbA(1c). However, efficacy on this biological criterion does not necessarily reflect clinical benefit to patients. Several randomized clinical trials have shown that antidiabetic drugs reduce HbA(1c) without a corresponding reduction in clinical events. This suggests a need to focus on the clinical effectiveness (morbimortality criteria) of our available antidiabetic drugs. In this non-extensive review of the literature, it was found that none of the current antidiabetic drugs have clearly proven their superiority over placebo in the gold standard double-blind randomized clinical trials. Thus, in 2013, the level of evidence for the clinical efficacy of antidiabetic drugs is disappointing and does not support the millions of prescriptions being written for them.
authors: Département de médecine générale, faculté de Poitiers, 11, route du Clos-Bardien, 86000 Poitiers, France. Electronic address: remy.boussageon2@wanadoo.fr.
authors: R
authors: R
authors: Boussageon
authors: UMR 5558, CNRS, 69622 Villeurbanne cedex, France; Clinical Pharmacology, Louis-Pradel Hospital, CHU de Lyon, 69677 Bron cedex, France.
authors: F
authors: F
authors: Gueyffier
authors: UMR 5558, CNRS, 69622 Villeurbanne cedex, France; Clinical Pharmacology, Louis-Pradel Hospital, CHU de Lyon, 69677 Bron cedex, France; Inserm, Clinical Investigation Center (CIC201), 69677 Bron cedex, France.
authors: C
authors: C
authors: Cornu
mesh_terms: D001786:Blood Glucose / Q000187:drug effects*; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D003925:Diabetic Angiopathies / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D006442:Glycated Hemoglobin / Q000187:drug effects; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D054795:Incretins / Q000627:therapeutic use; D007328:Insulin / Q000097:blood / Q000627:therapeutic use; D008687:Metformin / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D013453:Sulfonylurea Compounds / Q000627:therapeutic use
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D054795:Incretins; D007328:Insulin; D008687:Metformin; D013453:Sulfonylurea Compounds; C517652:hemoglobin A1c protein, human
keywords: Antidiabetic drugs; Clinical efficacy; Level of evidence; Type 2 diabetes