Contemporary Initial Glucose‐Lowering Strategies for Type 2 Diabetes: A Systematic Review and Bayesian Network Meta‐Analysis
Authors' conclusion
SGLT2i plus metformin and GLP-1 RA or dual incretin agonist therapy are both reasonable contemporary initial glucose-lowering strategies for type 2 diabetes.
Study context
- Population
- Adults with T2D who were treatment-naïve or had completed adequate washout
- Participants
- 8,947 adults20 RCTs
- Comparison
- SGLT2i monotherapy, GLP-1 RA or dual incretin agonist monotherapy, SGLT2i plus metformin, or placebo
- Outcome
- HbA1c reduction
Methodological detailsrandom-effects, All trials at low risk of bias
- Random-effects
- All trials at low risk of bias
Pooled result
As reported in the abstract
Each group vs placeboMD, % (95% CrI)
SGLT2i + metformin
−1.36(−1.91 to −0.82)
GLP-1 RA or dual incretin agonist
−1.25(−1.68 to −0.83)
SGLT2i
−0.76(−1.10 to −0.41)
Further pooled results
| Outcome | MD (%) (95% CrI) | |
|---|---|---|
| Body weight percentage reductionGLP-1 RA or dual incretin agonistvs PlaceboGreatest reduction · CrI | −4.74 (−6.71 to −2.90) | |
| −10−505Difference, % (linear scale) |
Achievement of HbA1c <7% and FPG reduction
- Showed a similar pattern to HbA1c reduction
Original publication
Contemporary Initial Glucose‐Lowering Strategies for Type 2 Diabetes: A Systematic Review and Bayesian Network Meta‐Analysis. Diabetes Obes Metab. Published 29 September 2026. doi:10.
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