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    Evaluar la eficacia de la metformina frente a placebo, dieta, antidiabéticos orales o insulina en la diabetes mellitus tipo 2. No existen ensayos clínicos a largo plazo que comparen con metformina los inhibidores de la *-glucosidasa, meglitinidas y tiazolidindionas, en resultados primarios. MEDLINE (1966-2003), EMBASE (1974-2003), LILACS (1986-2003), Cochrane library (Issue 3, 2003). 29 randomized clinical trials of metformin in monotherapy, with results on mortality, morbility, and biochemistry. Metformin decreased glycosylated hemoglobin A (weighted mean difference, ­1.21%; 95% CI, ­1.48 to ­0.94), low density lipoprotein cholesterol (weighted mean difference, ­0.24; 95% CI, ­0.40 to ­0.09), and weight (standardized mean difference, ­0.11; 95% CI, ­0.18 to ­0.04). La metformina presentó mayor beneficio que el placebo, la dieta o las tiazolidindionas en la hemoglobina A glucosilada, y que las sulfonilureas o la insulina en el peso. A largo plazo la metformina disminuye el riesgo de acontecimientos clínicos relacionados con la diabetes. Two reviewers extracted the data and evaluated the quality. Metformin was more beneficial than the sulphonylureas or insulin for any clinical event associated with diabetes (relative risk [RR]=0.78; 95% confidence interval [CI], 0.65-0.94) and than diet (RR=0.74; 95% CI, 0.60-0,90). MEDLINE (1966-2003), EMBASE (1974-2003), LILACS (1986- 2003), Cochrane library (Issue 3, 2003). Se seleccionaron 29 ensayos clínicos aleatorizados de metformina en monoterapia, con resultados sobre mortalidad, morbilidad y bioquímica. La metformina disminuyó la hemoglobina A glucosilada (diferencia media ponderada: ­1,21%; IC del 95%, ­1,48 a ­0,94), colesterol unido a lipoproteínas de baja densidad (diferencia media ponderada: ­0,24; IC del 95%, ­0,40 a ­0,09) y peso (diferencia media estandarizada: ­0,11; IC del 95%, ­0,18 a ­0,04). 29 clinical studies with 37 comparisons of metformin were analyzed (13 with sulphonylureas, 12 with placebo, 3 with diet, 3 with thiazolidinediones, 2 with *-glucosidase inhibitors, 2 with insulin, and 2 with meglitinides). Dos revisores extrajeron los datos y evaluaron la calidad. La metformina mostró mayor beneficio que las sulfonilureas o la insulina para cualquier acontecimiento clínico relacionado con la diabetes (riesgo relativo = 0,78; intervalo de confianza [IC] del 95%, 0,65 a 0,94) y que la dieta (riesgo relativo = 0,74; IC del 95%, 0,60 a 0,90). Se analizaron 29 ensayos clínicos con 37 comparaciones de metformina (13 con sulfonilureas, 12 con placebo, 3 con dieta, 3 con tiazolidindionas, 2 con inhibidores de la *-glucosidasa, 2 con insulina y 2 con meglitinidas). Las diferentes intervenciones comparadas con metformina no obtuvieron más beneficio para los resultados secundarios evaluados. Metformin was more beneficial than the placebo, diet or the thiazolidinediones on glycosylated hemoglobin A , and than the sulphonylureas or insulin on weight. In the long term metformin reduces the risks of clinical events associated with diabetes. To evaluate the efficacy of metformin against placebo, diet, oral anti-diabetics, or insulin in type 2 diabetes mellitus. There are no long term clinical trials which compare *-glucosidase inhibitors, meglitinides, and thiazolidinediones with metformin, in primary results. Monotherapy with Metformin vs. Sulfonylureas for Type 2. Dual Add-on Therapy in Type 2 Diabetes Poorly Controlled With. Comparative efficacy of glimepiride and metformin in.
     
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