Summary of findings for the main comparison. Summary of findings: sulphonylureas.
| Combinations of insulin and sulphonylureas compared with insulin monotherapy for diabetes mellitus | |||||
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Patient: participants with type 2 diabetes mellitus Settings: mostly secondary care outpatients and secondary care inpatients Intervention: sulphonylureas plus insulin Comparison: insulin monotherapy | |||||
| Outcomes | Insulin monotherapy | Insulin plus sulphonylureas | No of participants (studies) | Quality of the evidence (GRADE) | Comments |
| All‐cause mortality | See comment | See comment | See comment | See comment | Not investigated |
| Diabetes‐related mortality | See comment | See comment | See comment | See comment | Not investigated |
| Diabetes‐related morbidity | See comment | See comment | See comment | See comment | Not investigated |
| Health‐related quality of life | See comment | See comment | See comment | See comment | Not investigated |
| Patient satisfaction | See comment | See comment | See comment | See comment | Not investigated |
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Adverse events: a. mild hypoglycaemia (episodes per participant) Follow‐up: 12 weeks to 12 months b. weight gain (kg) Follow‐up: 8 weeks to 12 months |
a. range 2.0‐2.6 b. the mean weight gain across control groups ranged from ‐0.8 kg to 2.1 kg |
a. range 2.2‐6.1 b. the mean weight gain across intervention groups ranged from 0.4 kg to 1.9 kg |
a. 239 (8) b. 220 (7) |
a. ⊕⊕⊝⊝
lowa b. ⊕⊕⊝⊝ lowa |
a. Serious hypoglycaemic episodes were rare |
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HbA1c, change from baseline (%) Follow‐up: 2 to 12 months |
The mean change in HbA1c ranged across control groups from ‐1.5% to 3% | The mean change in HbA1c in the intervention groups was 1% lower (1.6% lower to 0.5% lower) | 316 (9) | ⊕⊕⊝⊝ lowb | ‐ |
| CI: confidence interval; HbA1c: glycosylated haemoglobin A1c | |||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | |||||
aDowngraded by two levels because of risk of performance and detection bias and indirectness bDowngraded by two levels because of risk of performance bias and indirectness