| Title |
Should Metformin Remain First-Line Medical Therapy for Patients with Type 2 Diabetes Mellitus and Atherosclerotic Cardiovascular Disease? An Alternative Approach
|
|---|---|
| Published in |
Current Diabetes Reports, July 2018
|
| DOI | 10.1007/s11892-018-1035-z |
| Pubmed ID | |
| Authors |
Josephine L. Harrington, Natalia de Albuquerque Rocha, Kershaw V. Patel, Subodh Verma, Darren K. McGuire |
| Abstract |
With recent cardiovascular outcome trial (CVOT) results for antihyperglycemic medications, the treatment algorithm for patients with type 2 diabetes (T2DM) and atherosclerotic vascular disease (ASCVD) requires revision. All completed CVOTs have demonstrated CV safety of the tested medications, with some trials demonstrating CV efficacy. While metformin remains the first-line recommended medication for T2DM, 18-37% of the patients enrolled in the completed CVOTs were not treated with metformin, providing substantial power to assess CV outcomes independent of metformin. The safety and tolerability of metformin are indisputable, but there are no robust data proving its efficacy for either macro or microvascular disease outcomes. We should reconsider the primacy of metformin in the management of T2DM in patients with ASCVD. This article will review the evidence for CV effects of antihyperglycemic agents (AHAs), and propose an evidence-based treatment algorithm for patients with T2DM and ASCVD. |
X Demographics
The data shown below were collected from the profiles of 13 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 9 | 69% |
| Venezuela, Bolivarian Republic of | 1 | 8% |
| United States | 1 | 8% |
| Unknown | 2 | 15% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 12 | 92% |
| Practitioners (doctors, other healthcare professionals) | 1 | 8% |
Mendeley readers
The data shown below were compiled from readership statistics for 29 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 29 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 6 | 21% |
| Student > Bachelor | 2 | 7% |
| Researcher | 2 | 7% |
| Other | 1 | 3% |
| Lecturer | 1 | 3% |
| Other | 5 | 17% |
| Unknown | 12 | 41% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 5 | 17% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 7% |
| Nursing and Health Professions | 2 | 7% |
| Biochemistry, Genetics and Molecular Biology | 1 | 3% |
| Agricultural and Biological Sciences | 1 | 3% |
| Other | 1 | 3% |
| Unknown | 17 | 59% |
Attention Score in Context
This research output has an Altmetric Attention Score of 7. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 August 2018.
All research outputs
#4,556,157
of 23,316,003 outputs
Outputs from Current Diabetes Reports
#237
of 1,019 outputs
Outputs of similar age
#86,189
of 327,759 outputs
Outputs of similar age from Current Diabetes Reports
#10
of 28 outputs
Altmetric has tracked 23,316,003 research outputs across all sources so far. Compared to these this one has done well and is in the 80th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,019 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.3. This one has done well, scoring higher than 76% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 327,759 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 73% of its contemporaries.
We're also able to compare this research output to 28 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 67% of its contemporaries.