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JAMA Clinical Evidence Synopsis
October 17, 2017

Oral Hypoglycemic Agents Added to Insulin Monotherapy for Type 2 Diabetes

Author Affiliations
  • 1Julius Center for Health Sciences and Primary Care, Department of General Practice, University Medical Center Utrecht, Utrecht, the Netherlands
JAMA. 2017;318(15):1489-1490. doi:10.1001/jama.2017.13463

Clinical Question  Among patients with type 2 diabetes mellitus who do not achieve optimal glycemic control with insulin monotherapy, is the addition of oral hypoglycemic agents associated with benefits (measured by lowering of hemoglobin A1c) or adverse effects?

Bottom Line  Adding a sulfonylurea to insulin was associated with more hypoglycemic events compared with insulin alone, but this association was not observed for metformin. Adding a sulfonylurea or metformin to insulin was associated with a decrease in hemoglobin A1c of approximately 1.0%.