磺脲类药物比二甲双胍导致更多的心肌梗死、卒中和死亡（在253,690名退伍军人中高21%）。
原始表述
السلفونيل يوريا ـ في أتراب 253,690 من قدامى المحاربين بقلم رومي ـ زاد الاحتشاء والسكتة والوفاة 21% مقارنة بالميتفورمين.
按来源为原话. 译文由本项目提供；以阿拉伯语原文为准。
译文
磺脲类药物比二甲双胍导致更多的心肌梗死、卒中和死亡（在253,690名退伍军人中高21%）。
出处
- 来源状态
- 档案网站编辑
- 归属
- Archive editors (not Elawady)
- 出处
- https://eltayebat.com/rule/oral-diabetes-drugs/
- 归属的不确定性
- Editorial narrative and study selection written by the archive operators.
- 所声称的健康影响
Cardiovascular events, death
- 涉及人群
Type 2 diabetes
- Elawady 设定的地域限制
none found
科学评估
可能正确 – 有一些证据支持该说法，但不足以得出明确判断。
证据确定性: 低 – 进一步研究很可能大幅改变该评估。
1. 说法是什么？
Sulfonylureas raise cardiovascular events and death vs metformin.
2. 哪些内容可证实是正确的？
Roumie: 18.2 vs 10.4 events per 1,000 person-years, aHR 1.21 (1.13-1.30) (A-ODD-07); similar observational signals for cancer mortality (A-INS-11) and composite endpoints (A-INS-08). UKPDS 34: metformin was better than sulfonylureas or insulin for any diabetes endpoint and all-cause mortality in overweight patients (I-ODD-01).
3. 哪些内容是错误或夸大的？
'Cause' cannot be concluded from a cohort. In ADVANCE, gliclazide-based intensive control reduced combined events without increasing death (I-INS-01); in UKPDS 33 sulfonylureas did not increase macrovascular disease (A-INS-16) and long-term follow-up showed fewer MIs and deaths (I-INS-02).
4. 哪些内容仍不明确？
Differences between sulfonylureas (glibenclamide vs gliclazide).
5. 哪些研究支持该说法？
6. 哪些研究与该说法相矛盾？
7. 对德国和欧洲而言情况如何？
European (EASD) and German (DDG) guidance follow the same evidence base as the ADA/EASD consensus: individualised HbA1c targets, insulin as mandatory therapy in type 1 diabetes, and SGLT2 inhibitors/GLP-1 receptor agonists for people with cardiovascular or kidney disease. No country-specific difference changes the assessment.
8. 关于埃及的已知情况是什么？
Sulfonylureas are widely used in Egypt because of low cost; their main practical risk is hypoglycaemia, especially with fasting (I-FAST-10).
9. 合理的实际结论是什么？
磺脲类是二线药物，有低血糖风险；随机对照试验并未显示它们会增加心血管死亡。
评估详情
- 证据确定性的依据
Observational cohort with careful adjustment (aHR 1.21) and consistent with Saskatchewan and UK data; but RCTs (UKPDS 33, ADVANCE with gliclazide) did not show cardiovascular harm, and UKPDS showed long-term benefit for sulfonylurea-insulin therapy. Comparative superiority of metformin is plausible (UKPDS 34).
- 来源质量
Archive editorial citing a retrospective cohort.
- 地区可推广性
US veterans, mostly white men.
- 说法的地域范围
- 普遍性（生物学/医学）
- 最近审核
- 2026年10月26日 初步
科学证据详解
过度解读 – 确有真实的发现，但该说法从中引申出的结论超出了数据所能支持的范围（例如把关联当作因果、把动物数据套用到人身上、把小效应说成大效应）。
研究问题: Do sulfonylureas cause more myocardial infarctions, strokes and deaths than metformin?
研究问题详解 (PICO)
- 人群
- Type 2 diabetes
- 干预或暴露
- Sulfonylureas
- 对照
- Metformin or other drugs
- 地域范围
- universal biology
- 结局指标
- MACE
- All-cause mortality
- Hypoglycaemia
研究结果按作者报告呈现。我们的评估见下文。
哪些证据支持该说法？
Sulfonylurea vs metformin as first drug
Roumie CL et al.. Ann Intern Med 2012 · PMID 23128859 · DOI 10.7326/0003-4819-157-9-201211060-00003 队列研究全文，含结构化偏倚风险评估US veterans cohort: sulfonylureas vs metformin.
- 实际结果
- aHR 1.21 (1.13-1.30); crude 18.2 vs 10.4 per 1,000 PY.
- 方法学质量
- moderate (observational)
- 相关性
- direct
- 局限
- Confounding (crude ratio 1.75 vs adjusted 1.21).
816 trials: what each diabetes drug class does and does not do
NMA: sulfonylureas possibly increase all-cause mortality.
- 实际结果
- Low certainty; severe hypoglycaemia OR 5.22.
- 方法学质量
- high review, low-certainty outcome
- 相关性
- direct
- 局限
- Low certainty.
哪些证据不支持该说法？
Trials do not prove that sulfonylureas cause more deaths
Varvaki Rados D et al.. PLoS Med 2016 · PMID 27071029 · DOI 10.1371/journal.pmed.1001992 Meta分析已核查全文新增Meta-analysis of 47 RCTs: no significant increase in death, MI or stroke.
- 实际结果
- All-cause OR 1.12 (0.96-1.30); MI OR 0.92 (0.76-1.12).
- 方法学质量
- moderate
- 相关性
- direct
- 局限
- Trials not designed for safety.
Glimepiride vs linagliptin: same heart outcomes, far more low blood sugar
CAROLINA: glimepiride had the same MACE rate as linagliptin.
- 实际结果
- 11.8% vs 12.0%; HR 0.98 (0.84-1.14).
- 方法学质量
- high (RCT)
- 相关性
- indirect (comparator not metformin)
总体证据说明了什么？
基于上述研究的编辑评估——其本身并非研究结果。
哪种观点有更好的证据支持？
Observational studies consistently find more events with sulfonylureas than metformin, and metformin did better in UKPDS 34, but RCTs do not show that sulfonylureas cause cardiovascular harm; the established risk is hypoglycaemia.
为什么有些研究权重更大
RCT data weigh more than confounded cohorts for causation.
因果关系是否已确立？ 尚未确立 Association is consistent; RCTs neutral.
仍存在的不确定性
Agent differences (glibenclamide vs gliclazide/glimepiride).
合理的结论
Potentially true as a comparison; 'cause' is not established.
为什么研究结果看起来互相矛盾？
Cohorts compare patients who were selected for sulfonylureas (often sicker; strong difference between crude and adjusted estimates), whereas RCTs randomise; residual confounding likely explains part of the difference.
这是否取决于国家？
- 一般生物学效应
- Drug pharmacology and physiology are universal.
- 饮食习惯
- Prolonged fasting, Ramadan fasting and very-low-carbohydrate eating change the risk of hypoglycaemia and ketoacidosis with some drugs; relevant in Egypt and among Muslims in Europe.
- 食品原产地
- Not applicable.
- 污染物
- Not applicable.
- 本国生产条件
- Not applicable (same active substances; generics widely used in Egypt).
- 法律规则
- Drug labels and warnings are set by FDA/EMA and national regulators; Egyptian labelling not reviewed.
- 实际监测数据
- No Egypt-specific pharmacovigilance data were found for this outcome.
足以改变结论的地区差异没有可靠数据支持。
统计复核
- Crude vs adjusted – Crude rate ratio 1.75 vs aHR 1.21: strong baseline imbalance. 已重新计算
- Absolute differences – MACE -0.25 percentage points (CI -1.88 to 1.38); hypoglycaemia +27 percentage points with glimepiride (NNH about 4). 已重新计算
总体证据的确定性（GRADE，简化版）
- 主要结局
- Cardiovascular events/mortality with sulfonylureas vs metformin
- 起始等级
- 高（随机试验）
- 降级理由
- imprecision
- indirectness (few head-to-head RCTs vs metformin)
- 结果
- 低
由单名审查者参照 GRADE 方法进行的简化评估；并非正式的 GRADE 专家组评估。GRADE 评价的是针对某一结局的整体证据，而非单项研究。
已核查的临床指南和官方声明
- ADA: 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes-2026 (Diabetes Care 2026;49 Suppl 1) (2026) · 原始文献
Sulfonylureas listed with FDA special warning based on tolbutamide; glimepiride shown to be CV safe; reassess sulfonylurea doses to minimise hypoglycaemia (rec. 9.17).
检索策略
本次审查的文献检索记录（检索式采用原数据库语法）。
| 数据库 | 日期 | 检索式 | 检索目标 | 命中数 | 纳入数 |
|---|---|---|---|---|---|
| PubMed | 2026年10月26日 | (sulfonylurea*[ti] OR glimepiride[ti] OR gliclazide[ti]) AND (mortality[ti] OR cardiovascular[ti]) AND (randomized controlled trial[pt] OR meta-analysis[pt]) | 反对性证据 | 27 | |
| Europe PMC | 2026年10月26日 | (TITLE:sulfonylurea OR TITLE:sulphonylurea) AND (TITLE:metformin) AND (TITLE:mortality OR TITLE:cardiovascular) AND (cohort OR "meta-analysis") | 支持性证据 | 17 | |
| PubMed | 2026年10月26日 | (glimepiride[tiab] OR sulfonylurea*[tiab]) AND (cardiovascular outcome*[tiab] OR MACE[tiab]) AND randomized controlled trial[pt] AND 2015:2026[dp] | 反对性证据 | 15 |
待解决的问题
Agent-specific long-term safety.
核查深度如何？
9 项相关研究：5 项核查了全文（其中 3 项进行了结构化偏倚风险评估），4 项基于摘要核查，0 项仅核查了文献信息。 尚未进行由两名独立审查者完成的正式评估，也尚未进行独立的人类专家审核。
最近一次科学审核: 2026年10月26日
通俗解释
一项大型数据库研究发现，开始服用磺脲类药片的人比开始服用二甲双胍的人有更多心脏病发作和死亡。随机对照试验并未显示这种危害，尽管二甲双胍的效果稍好一些。磺脲类药物的主要已知问题是低血糖，尤其是在不吃饭或禁食时。
与该说法相关的研究
支持该说法的研究 (3)
-
Sulfonylurea vs metformin as first drug
Roumie CL et al.. Ann Intern Med 2012 · PMID 23128859 · DOI 10.7326/0003-4819-157-9-201211060-00003队列研究被 Tayebat 档案网站引用全文，含结构化偏倚风险评估★ 关键研究Starting a sulfonylurea instead of metformin was linked to about 1-4 extra heart events or deaths per 1,000 people per year.
该研究是否支持这一具体说法？ 部分支持 · 方法学质量: 中 · 证据确定性：见该说法的总体评估
研究通俗解读
- 研究人员想了解什么？
Sulfonylurea vs metformin monotherapy on CVD events/death
- 研究是如何开展的？
Retrospective cohort (VHA + Medicare) with propensity-matched sensitivity analysis
- 研究了多少人、动物或样本？
253,690; Veterans initiating metformin or SU, excluding CKD and serious illness
- 实际发现了什么？
aHR 1.21.
- 观察到的效应有多大？
aHR 1.21 (1.13-1.30)
- 研究结果对日常生活意味着什么？
Metformin is preferred first-line.
- 该研究有哪些局限？
Observational; mostly white men; under 1 year median follow-up; many stopped treatment; possible residual confounding.
- 它对 Elawady 的具体说法说明了什么？
Supports C-ODD-11.
- 研究结果是否适用于德国和欧洲？
US veterans.
- 从该研究中明确不能得出什么结论？
That sulfonylureas cause death.
-
UK database: insulin users vs metformin users
Currie CJ et al.. J Clin Endocrinol Metab 2013 · PMID 23372169 · DOI 10.1210/jc.2012-3042队列研究被 Tayebat 档案网站引用全文，含结构化偏倚风险评估★ 关键研究People treated with insulin alone had about twice the death rate of metformin users, but they were also sicker.
该研究是否支持这一具体说法？ 部分支持 · 方法学质量: 极低 · 证据确定性：见该说法的总体评估
研究通俗解读
- 研究人员想了解什么？
Risk of adverse events with five glucose-lowering regimens
- 研究是如何开展的？
Retrospective cohort, UK General Practice Research Database
- 研究了多少人、动物或样本？
84,622 patients; 105,123 exposure periods; Primary care type 2 diabetes
- 实际发现了什么？
Insulin monotherapy associated with higher risks of death, MACE, cancer, complications.
- 观察到的效应有多大？
aHR 2.197 death
- 研究结果对日常生活意味着什么？
Shows insulin users fare worse, not that insulin causes it.
- 该研究有哪些局限？
Insulin users had longer diabetes (5.2 vs 1.5 years), more kidney and heart disease; ~3 years follow-up; censoring at treatment switch; authors note confounding by indication; authors have industry ties.
- 它对 Elawady 的具体说法说明了什么？
Main observational support for C-INS-05.
- 研究结果是否适用于德国和欧洲？
UK data.
- 从该研究中明确不能得出什么结论？
That insulin causes death, cancer or kidney failure; any insulin dose-response.
-
Metformin in overweight type 2 diabetes (UKPDS 34)
UKPDS Group. Lancet 1998 · PMID 9742977随机对照试验独立交叉核查已核查摘要★ 关键研究Metformin reduced deaths from any cause by about a third over 10 years.
该研究是否支持这一具体说法？ 否 · 方法学质量: 中 · 证据确定性：见该说法的总体评估
研究通俗解读
- 研究人员想了解什么？
Intensive control with metformin in overweight type 2 diabetes
- 研究是如何开展的？
RCT within UKPDS (UKPDS 34)
- 研究了多少人、动物或样本？
753 (main comparison); Overweight newly diagnosed type 2 diabetes, mean age 53
- 实际发现了什么？
Mortality -36%.
- 观察到的效应有多大？
RR reduction 36% (9-55)
- 研究结果对日常生活意味着什么？
Metformin is protective.
- 该研究有哪些局限？
Small arms; Open-label; Conflicting supplementary result
- 它对 Elawady 的具体说法说明了什么？
- 研究结果是否适用于德国和欧洲？
UK.
- 从该研究中明确不能得出什么结论？
Effects in non-overweight patients.
该组中没有被标记为关键研究的研究。
与该说法相矛盾或限制该说法的研究 (5)
-
ADVANCE: intensive control to HbA1c 6.5%
ADVANCE Collaborative Group; Patel A et al.. N Engl J Med 2008 · PMID 18539916 · DOI 10.1056/NEJMoa0802987随机对照试验独立交叉核查全文，含结构化偏倚风险评估★ 关键研究Fewer kidney complications and no extra deaths, but more severe hypoglycaemia.
该研究是否支持这一具体说法？ 否 · 方法学质量: 高 · 证据确定性：见该说法的总体评估
研究通俗解读
- 研究人员想了解什么？
Effect of intensive glucose control (gliclazide MR-based, HbA1c <=6.5%) on vascular outcomes
- 研究是如何开展的？
Multicentre factorial RCT (ADVANCE glucose arm)
- 研究了多少人、动物或样本？
11,140; Type 2 diabetes with high vascular risk
- 实际发现了什么？
10% fewer combined events; no mortality difference.
- 观察到的效应有多大？
HR 0.90 (0.82-0.98)
- 研究结果对日常生活意味着什么？
Moderately intensive control is safe and protects kidneys.
- 该研究有哪些局限？
Open-label; kidney benefit mainly less protein in urine; underpowered for heart attacks/strokes; funded by the drug's manufacturer (analysis independent).
- 它对 Elawady 的具体说法说明了什么？
- 研究结果是否适用于德国和欧洲？
Multinational trial including European sites or directly applicable to EU practice.
- 从该研究中明确不能得出什么结论？
Benefit for heart attacks/stroke.
-
UKPDS: tablets or insulin for new type 2 diabetes
UKPDS Group. Lancet 1998 · PMID 9742976随机对照试验被 Tayebat 档案网站引用已核查摘要★ 关键研究Better sugar control with tablets or insulin cut eye/kidney complications by a quarter; insulin caused more weight gain and low-sugar episodes.
该研究是否支持这一具体说法？ 部分支持 · 方法学质量: 高 · 证据确定性：见该说法的总体评估
研究通俗解读
- 研究人员想了解什么？
Intensive control with sulfonylurea or insulin vs diet on complications
- 研究是如何开展的？
Multicentre RCT (UKPDS 33)
- 研究了多少人、动物或样本？
3,867; Newly diagnosed type 2 diabetes, median age 54
- 实际发现了什么？
Microvascular -25%; more hypoglycaemia and weight gain with insulin.
- 观察到的效应有多大？
RR reduction 25% microvascular
- 研究结果对日常生活意味着什么？
Insulin helps prevent complications but has side effects.
- 该研究有哪些局限？
Open-label; Older drug regimens
- 它对 Elawady 的具体说法说明了什么？
- 研究结果是否适用于德国和欧洲？
UK; directly relevant.
- 从该研究中明确不能得出什么结论？
That insulin is harmful overall.
-
UKPDS legacy: 10 years after the trial
Holman RR et al.. N Engl J Med 2008 · PMID 18784090 · DOI 10.1056/NEJMoa0806470随机对照试验独立交叉核查已核查摘要★ 关键研究People treated intensively early with sulfonylureas or insulin had 15% fewer heart attacks and 13% fewer deaths years later.
该研究是否支持这一具体说法？ 否 · 方法学质量: 高 · 证据确定性：见该说法的总体评估
研究通俗解读
- 研究人员想了解什么？
Do UKPDS benefits persist and do macrovascular effects emerge?
- 研究是如何开展的？
Post-trial monitoring of an RCT (UKPDS 80)
- 研究了多少人、动物或样本？
4,209 randomised; 3,277 monitored; Newly diagnosed type 2 diabetes from UKPDS
- 实际发现了什么？
Legacy reductions in MI and death.
- 观察到的效应有多大？
Death -13% (SU/insulin), -27% (metformin)
- 研究结果对日常生活意味着什么？
Early good control pays off for decades.
- 该研究有哪些局限？
Post-trial therapy not controlled; Questionnaire follow-up
- 它对 Elawady 的具体说法说明了什么？
- 研究结果是否适用于德国和欧洲？
UK; directly relevant.
- 从该研究中明确不能得出什么结论？
Effects of extreme targets in late disease.
-
Trials do not prove that sulfonylureas cause more deaths
Varvaki Rados D et al.. PLoS Med 2016 · PMID 27071029 · DOI 10.1371/journal.pmed.1001992Meta分析独立交叉核查已核查全文★ 关键研究All-cause mortality OR 1.12 (0.96-1.30); MI OR 0.92.
All-cause OR 1.12 (0.96-1.30), MI OR 0.92 in RCTs.
该研究是否支持这一具体说法？ 否 · 方法学质量: 中 · 证据确定性：见该说法的总体评估
研究通俗解读
- 研究人员想了解什么？
Assess sulfonylurea safety in RCTs.
- 研究是如何开展的？
Meta-analysis of 47 RCTs with TSA.
- 研究了多少人、动物或样本？
37,650 patients.
- 实际发现了什么？
No significant increase in death, MI or stroke.
- 观察到的效应有多大？
OR 1.12 (0.96-1.30).
- 研究结果对日常生活意味着什么？
Sulfonylureas have not been shown to cause heart deaths in trials, but low blood sugar remains their main risk.
- 该研究有哪些局限？
Trials not designed for safety.
- 它对 Elawady 的具体说法说明了什么？
Contradicts 'cause' as an established fact.
- 研究结果是否适用于德国和欧洲？
High.
- 从该研究中明确不能得出什么结论？
A small harm.
-
Glimepiride vs linagliptin: same heart outcomes, far more low blood sugar
Rosenstock J et al.. JAMA 2019 · PMID 31536101 · DOI 10.1001/jama.2019.13772随机对照试验独立交叉核查已核查摘要MACE 12.0% vs 11.8%; hypoglycaemia 37.7% vs 10.6%.
Glimepiride MACE equal to linagliptin (HR 0.98).
该研究是否支持这一具体说法？ 否 · 方法学质量: 高 · 证据确定性：见该说法的总体评估
研究通俗解读
- 研究人员想了解什么？
Compare cardiovascular outcomes of glimepiride and linagliptin.
- 研究是如何开展的？
Blinded RCT.
- 研究了多少人、动物或样本？
6,033 patients.
- 实际发现了什么？
Equal cardiovascular events; more hypoglycaemia with glimepiride.
- 观察到的效应有多大？
HR 0.98 (0.84-1.14).
- 研究结果对日常生活意味着什么？
The main problem with sulfonylureas is low blood sugar, not heart attacks.
- 该研究有哪些局限？
No metformin comparison.
- 它对 Elawady 的具体说法说明了什么？
Limits the claim.
- 研究结果是否适用于德国和欧洲？
High.
- 从该研究中明确不能得出什么结论？
Comparison with metformin.
该组中没有被标记为关键研究的研究。
结果不一或不明确的研究 (1)
-
816 trials: what each diabetes drug class does and does not do
Shi Q et al.. BMJ 2023 · PMID 37024129 · DOI 10.1136/bmj-2022-074068Meta分析独立交叉核查已核查全文★ 关键研究SGLT2 inhibitors and GLP-1 agonists reduce death by about 12%; each class has specific side effects.
Sulfonylureas possibly increase all-cause mortality (low certainty) and clearly increase severe hypoglycaemia.
该研究是否支持这一具体说法？ 部分支持 · 方法学质量: 高 · 证据确定性：见该说法的总体评估
研究通俗解读
- 研究人员想了解什么？
Compare benefits and harms of all diabetes drug classes.
- 研究是如何开展的？
Network meta-analysis of 816 RCTs with GRADE.
- 研究了多少人、动物或样本？
471,038 patients.
- 实际发现了什么？
Mortality benefit for SGLT2i and GLP-1 RA; class-specific harms such as DKA and genital infections (SGLT2i), hypoglycaemia (sulfonylureas, insulin), heart failure (TZDs).
- 观察到的效应有多大？
Death OR 0.88; DKA OR 2.07; amputation OR 1.27.
- 研究结果对日常生活意味着什么？
No drug is free of side effects; for several classes the benefits clearly outweigh them in people at risk.
- 该研究有哪些局限？
Low certainty for older drugs.
- 它对 Elawady 的具体说法说明了什么？
Supports 'every class has harms'; refutes 'net harmful'.
- 研究结果是否适用于德国和欧洲？
High.
- 从该研究中明确不能得出什么结论？
Individual treatment choice.
该组中没有被标记为关键研究的研究。
地区背景
德国 / 欧盟
European (EASD) and German (DDG) guidance follow the same evidence base as the ADA/EASD consensus: individualised HbA1c targets, insulin as mandatory therapy in type 1 diabetes, and SGLT2 inhibitors/GLP-1 receptor agonists for people with cardiovascular or kidney disease. No country-specific difference changes the assessment.
埃及
Sulfonylureas are widely used in Egypt because of low cost; their main practical risk is hypoglycaemia, especially with fasting (I-FAST-10).
在我的国家适用什么？
一般科学评估
可能正确 这是一个观察性信号，未得到试验证实；低血糖才是已确定的风险。
该说法涉及生物学或医学关系。上述科学评估不论在哪个国家都适用；各国食品数据不会改变这一评估。
参考文献
- Comparative effectiveness of sulfonylurea and metformin monotherapy on cardiovascular events in type 2 diabetes mellitus: a cohort study.. Roumie CL et al.. Ann Intern Med 2012 · PMID 23128859 · DOI 10.7326/0003-4819-157-9-201211060-00003
- Mortality and other important diabetes-related outcomes with insulin vs other antihyperglycemic therapies in type 2 diabetes.. Currie CJ et al.. J Clin Endocrinol Metab 2013 · PMID 23372169 · DOI 10.1210/jc.2012-3042
- Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group.. UKPDS Group. Lancet 1998 · PMID 9742977
- Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes.. ADVANCE Collaborative Group; Patel A et al.. N Engl J Med 2008 · PMID 18539916 · DOI 10.1056/NEJMoa0802987
- Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group.. UKPDS Group. Lancet 1998 · PMID 9742976
- 10-year follow-up of intensive glucose control in type 2 diabetes.. Holman RR et al.. N Engl J Med 2008 · PMID 18784090 · DOI 10.1056/NEJMoa0806470
- The Association between Sulfonylurea Use and All-Cause and Cardiovascular Mortality: A Meta-Analysis with Trial Sequential Analysis of Randomized Clinical Trials.. Varvaki Rados D et al.. PLoS Med 2016 · PMID 27071029 · DOI 10.1371/journal.pmed.1001992
- Effect of Linagliptin vs Glimepiride on Major Adverse Cardiovascular Outcomes in Patients With Type 2 Diabetes: The CAROLINA Randomized Clinical Trial.. Rosenstock J et al.. JAMA 2019 · PMID 31536101 · DOI 10.1001/jama.2019.13772
- Benefits and harms of drug treatment for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials.. Shi Q et al.. BMJ 2023 · PMID 37024129 · DOI 10.1136/bmj-2022-074068