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July 28, 2010

Adding Noninsulin Antidiabetic Drugs to Metformin Therapy for Type 2 Diabetes—Reply

JAMA. 2010;304(4):405-407. doi:10.1001/jama.2010.1022

In Reply: Drs Giugliano and Esposito describe as scanty the data supporting our conclusion that all (noninsulin) drug classes added to stable and maximal metformin achieve similar rates of HbA1c less than 7%. We share their concern that only 52% of included trials reported this end point, as it may suggest the presence of selective outcome reporting in some trials. Unfortunately, selective outcome reporting occurs too often in medical studies; meta-analyses based on these studies are subject to some degree of publication bias, since they may be drawing conclusions on less than all the data.1