Comparing Safety and Efficacy of Medications for Type 2 Diabetes

Recent concerns about the risks associated with rosiglitazone (a thiazolidinedione) have increased interest in the safety and efficacy of all oral agents for type 2 diabetes. Researchers recently reviewed the literature to summarize the risks and benefits of these drugs; they identified 216 controlled trials and cohort studies and two systematic reviews.

Too few randomized controlled trials have been performed to provide definitive comparative evidence regarding effects on mortality and diabetes-related morbidity. Most agents improved hemoglobin A_1C to the same degree as second-generation sulfonylureas (by about 1%); adding a second agent led to an additional one-percentage-point decrease. Nateglinide (Starlix; a nonsulfonylurea insulin secr…