Study: Metformin best first-line diabetes treatment

NEW YORK — While several drugs to treat Type 2 diabetes are on the market, researchers have found that the best first-line option is metformin.

Led by Wendy Bennett, an assistant professor of medicine at Johns Hopkins University School of Medicine in Baltimore, researchers reviewed 140 trials and 26 observational studies of head-to-head comparisons of monotherapy or combination therapy that reported intermediate or long-term clinical outcomes or harms of six oral diabetes medications.

Despite the fact that all of the drugs — metformin, second-generation sulfonylureas, thiazolidinediones, meglitinides, dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists — reduced hemoglobin A1C levels as either a monotherapy or combination therapy, metformin proved to be the most efficacious for posing the least amount of risks.

The other treatments, study authors noted, posed a higher risk of such conditions as hypoglycemia, congestive heart failure and bone fractures.

"Metformin continues to be an inexpensive medication, and it's very efficacious," Bennett said.

The study was published in the Annals of Internal Medicine.