American Association of Clinical Endocrinologists’ Comprehensive Diabetes Management Algorithm 2013 Consensus Statement

Garber, Alan J.; Abrahamson, Martin J.; Barzilay, Joshua I.; Blonde, Lawrence; Bloomgarden, Zachary T.; Bush, Michael D.; Dagogo‐Jack, Samuel; Davidson, Michael; Einhorn, Daniel; Garvey, W. Timothy; Grunberger, George; Handelsman, Yehuda; Hirsch, Irl B.; Jellinger, Paul S.; McGill, Janet B.; Mechanick, Jeffrey I.; Rosenblit, Paul D.; Umpiérrez, Guillermo E.; Davidson, Michael

doi:10.4158/ep13176.csuppl

Cited by 148 publications

(123 citation statements)

References 245 publications

(30 reference statements)

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“…One of our subgroup analyses showed that metformin raised serum Hcy in the patients without folic acid or Vitamin B 12 supplementation, but reduced Hcy when folic acid or Vitamin B 12 was supplemented, indicating that metformin-associated Vitamin B 12 reduction might be responsible for Hcy elevation, and exogenous folic acid and Vitamin B 12 may rescue the methionine metabolic disturbance in metformin-treated patients. Considering Hcy as an important biomarker of a series of diseases and the few adverse effects of folic acid and Vitamin B 12 , exogenous supplementation of these two vitamins could be necessary for metformin-treated patients, which is consistent with the recommendation of regular Vitamin B 12 supplementation in the current American Association of Clinical Endocrinologists (AACE) guideline [51]. However, this recommendation had not yet been supported by well-designed randomized trials.…”

Section: Discussionmentioning

confidence: 83%

Metformin Treatment and Homocysteine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Zhang

et al. 2016

Value in Health

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Abstract:The aim of this systematic review is to assess whether metformin could change the concentration of serum homocysteine (Hcy) with and without simultaneous supplementation of B-group vitamins or folic acid. A literature search was conducted in PubMed, EmBase, and Cochrane Central Register of Controlled Trials (CENTRAL) to identify randomized controlled trials (RCTs) reporting the concentration of serum Hcy in metformin-treated adults. Meta-analysis was applied to assess the association between metformin and the changes of Hcy concentration. Twelve publications were included in this study. In the overall analysis, metformin administration was not statistically associated with the change of Hcy when compared with the control treatment (mean difference (MD), 0.40 µmol/L; 95% confidence interval (CI), −0.07~0.87 µmol/L, p = 0.10). In the subgroup analysis, metformin was significantly associated with an increased concentration of Hcy in the absence of exogenous supplementation of folic acid or B-group vitamins (MD, 2.02 µmol/L; 95% CI, 1.37~2.67 µmol/L, p < 0.00001), but with a decreased concentration of serum Hcy in the presence of these exogenous supplementations (MD, −0.74 µmol/L; 95% CI, −1.19~−0.30 µmol/L, p = 0.001). Therefore, although the overall effect of metformin on the concentration of serum Hcy was neutral, our results suggested that metformin could increase the concentration of Hcy when exogenous B-group vitamins or folic acid supplementation was not given.

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Section: Discussionmentioning

confidence: 83%

Metformin Treatment and Homocysteine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Zhang

et al. 2016

Value in Health

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“…1,2 However, there are barriers to current treatment options, including limited glycemic durability, 3 AEs such as hypoglycemia and weight gain, 4,5 and injectable route of administration. T…”

Section: Commentarymentioning

confidence: 99%

Efficacy and Safety of Canagliflozin as Add-On Therapy to Metformin in Type 2 Diabetes

Battise¹

2014

Clinical Diabetes

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“…These factors may result in increased resource utilization and a rise in the overall costs associated with diabetes management 9 . Clinical guidelines support the add-on of basal insulin to existing regimens in people not achieving glycemic goals while receiving oral glucose-lowering drugs (OGLDs) [10][11][12] . In randomized clinical trials (RCTs) in insulin-naïve people with T2D, basal insulin analogs have demonstrated better glycemic control with a lower risk of hypoglycemia compared with human neutral protamine Hagedorn (NPH) insulin [13][14][15][16][17][18] .…”

Section: Introductionmentioning

confidence: 99%

An analysis of the cost-effectiveness of starting insulin detemir in insulin-naïve people with type 2 diabetes

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Baik

Gálvez

et al. 2014

Journal of Medical Economics

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Aims:There is limited evidence with respect to the cost-effectiveness of starting insulin in people with diabetes outside the 'western' world. The aim of this study was to assess the cost-effectiveness of starting basal insulin treatment with insulin detemir in people with type 2 diabetes (T2D) inadequately controlled on oral glucose-lowering drugs (OGLDs) in Mexico, South Korea, India, Indonesia, and Algeria. Methods:The IMS CORE Diabetes Model was used to project clinical and cost outcomes over a 30-year time horizon. Clinical outcomes, baseline characteristics and health state utility data were taken from the A 1 chieve study. A 1-year analysis was also conducted based on treatment costs and quality-of-life data. Incremental costeffectiveness ratios (ICERs) were expressed as a fraction of GDP per capita, and WHO-CHOICE recommendations (ICER53.0) used to define cost-effectiveness. Results:Starting insulin detemir was associated with a projected increase in life expectancy (!1 year) and was considered cost-effective in all of the studied populations with ICERs of À0.02 (Mexico), 0.00 (South Korea), 0.48 (India), 0.12 (Indonesia), and 0.88 (Algeria) GDP/quality-adjusted life-year. Cost-effectiveness was maintained after conducting sensitivity analyses in the 30-year and 1-year analyses. A projected increase in treatment costs was partially offset by a reduction in complications. The difference in overall costs between insulin detemir and OGLDs alone was USD518, 1431, 3510, 15, and 5219, respectively. Conclusion:Changes in clinical outcomes associated with starting insulin detemir in insulin-naïve individuals with T2D resulted in health gains that made the intervention cost-effective in five countries with distinct healthcare resources.

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American Association of Clinical Endocrinologists’ Comprehensive Diabetes Management Algorithm 2013 Consensus Statement

Cited by 148 publications

References 245 publications

Metformin Treatment and Homocysteine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Metformin Treatment and Homocysteine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Efficacy and Safety of Canagliflozin as Add-On Therapy to Metformin in Type 2 Diabetes

An analysis of the cost-effectiveness of starting insulin detemir in insulin-naïve people with type 2 diabetes

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