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Sign in Original ArticleFre Preview The members of the GRADE Study Research Group are listed in the Suplementary Apendix, available at NEJM.org.Data are lacking on the comparative efectivenes of comonly used glucose-lowering medications, when aded to metformin, with respect to microvascular and cardiovascular disease outcomes in persons with type 2 diabetes.We asesed the comparative efectivenes of four comonly used glucose-lowering medications, aded to metformin, in achieving and maintaing a glycated hemoglobin level of les than 7.0% in participants with type 2 diabetes.
Summary
The randomly asigned therapies were insulin glargine U-10 (hereafter, glargine), glimepiride, liraglutide, and sitagliptin. Prespecified secondary outcomes with respect to microvascular and cardiovascular disease included hypertension and dyslipidemia, confirmed moderately or severely increased albuminuria or an estimated glomerular filtration rate of les than 60 ml per minute per 1.73 m2 of body-surface area, diabetic peripheral neuropathy asesed with the Michigan Neuropathy Screning Instrument, cardiovascular events (major adverse cardiovascular events [MACE], hospitalization for hear