Table 4.
Individual examples of type 2 diabetes patients from the U.S. National Health and Nutrition Examination Survey (2003-2014, N = 1,107), incorporating results from recent trials on improved cardiovascular disease outcomes from some second-line glycemic therapies 42
| Covariate | Person 1 | Person 2 | Person 3 | Person 4 |
|---|---|---|---|---|
| Sex | Female | Female | Male | Male |
| Age | 47 | 44 | 63 | 66 |
| Race | Hispanic | Black | White | Black |
| SBP (mmHg) | 137 | 95 | 128 | 116 |
| Statin use | No | No | No | No |
| Anticoagulant use | No | No | No | No |
| BP medication use | No | Yes | Yes | Yes |
| Currently smoking | No | Yes | No | No |
| Oral diabetes medication use | No | No | No | No |
| Total cholesterol (mg/dL) | 188 (4.9 mmol/L) |
106 (2.7 mmol/L) |
195 (5.1 mmol/L) |
122 (3.2 mmol/L) |
| HDL cholesterol (mg/dL) | 44 (1.1 mmol/L) |
36 (0.9 mmol/L) |
69 (1.8 mmol/L) |
25 (0.6 mmol/L) |
| Hemoglobin A1c (%) | 7.5 (58.5 mmol/mol) |
9.1 (76.0 mmol/mol) |
8.0 (63.9 mmol/mol) |
11.4 (101.1 mmol/mol) |
| Serum creatinine (mg/DL) | 0.6 (53.0 μmol/L) |
0.7 (61.9 μmol/L) |
1.9 (168.0 μmol/L) |
2.32 (205.1 μmol/L) |
| Urine albumin creatine ratio (mg/g) | 54.2 | 7.6 | 68.8 | 60.0 |
| CVD history | Yes | Yes | No | Yes |
| CVD risk (10-yr risk, %) | Low | High | Low | High |
| Myocardial infarction | 8 | 12 | 7 | 56 |
| Stroke | 2 | 2 | 5 | 34 |
| Microvascular risk (10-yr risk, %) | Low | Low | High | High |
| Nephropathy | 8 | 7 | 23 | 58 |
| Retinopathy | 6 | 5 | 17 | 26 |
| Neuropathy | 7 | 7 | 16 | 23 |
| Drug ranking score (95% CI) based on network meta-analysis22 * | ||||
| 1st, ranking score normalized to 1 [uncertainty scale around being best value of 1] | SGLT-2-i 1.0 [0.83,1.47] |
SGLT-2-i 1.0 [0.83,1.47] |
GLP-1RA 1.0 [0.59,1.56] |
SGLT-2-i 1.0 [0.82,1.56] |
| 2nd | GLP-1RA 0.99 [0.59,1.56] |
GLP-1RA 0.99 [0.59,1.56] |
SGLT-2-i 0.99 [0.83,1.47] |
GLP-1RA 0.99 [0.59,1.66] |
| 3rd | Basal insulin 0.86 [0.33,1.60] |
Basal insulin 0.86 [0.33,1.61] |
Basal insulin 0.86 [0.34,1.61] |
Basal insulin 0.84 [0.35,1.75] |
| 4th | TZD 0.84 [0.59,1.33] |
TZD 0.84 [0.60,1.33] |
TZD 0.84 [0.60,1.34] |
TZD 0.82 [0.58,1.39] |
| 5th | SU 0.83 [0.53,1.39] |
SU 0.83 [0.53,1.39] |
SU 0.83 [0.53,1.39] |
SU 0.80 [0.52,1.45] |
| 6th | DPP-4-i 0.73 [0.49,1.31] |
DPP-4-i 0.73 [0.49,1.31] |
DPP-4-i 0.73 [0.49,1.32] |
DPP-4-i 0.69 [0.49,1.40] |
Preference weights: Only macrovascular and microvascular outcomes were considered important, accounting for the disability weights associated with disease outcomes.36-40
Drug ranking scores were normalized by the best ranking score. Score of 1 refers to the best ranking score, and the scores for other drugs are ranking scores relative the best ranking score. 95% confidence intervals were generated based on the uncertainty around the treatment effect estimates from the network meta-analysis.
TZD: Thiazolidinedione; SU: Sulfonylurea; GLP-1RA; GLP-1 agonist; SGLT-2-I; SGLT-2 inhibitor; DPP-4-I; DPP-4 inhibitor