Condition
Diabetes mellitus type 2
Clinical trials and treatment information for Diabetes mellitus type 2
506M
People Affected
300
Active Trials
24M
New Cases/Year
1.6M
Deaths/Year
Treatment Rankings
Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.
1
Insulin (Basal)
92% Effectiveness• 95% Confidence• 55% Safety• 392 trials• 500K participants
HIGH EvidencePoor ValueDose: 0.2-1.0 units/kg/day, individualized
Comparative Safety Scale(Higher is safer)
Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
55
DangerousModerateSafe
Time to Effect
Immediate to hours
Duration
Lifetime
Response Rate
88%
Remission Rate
%
Number Needed to Treat (NNT)
2
Number Needed to Harm (NNH)
7
Common Side Effects:
Hypoglycemia (mild-moderate): 30%
Weight gain: 8%
Injection site reactions: 2%
Lipohypertrophy: 7%
Annual Cost of Care
Drug Cost
$6,000
Monitoring
$1,000
Side Effects
$200
Total Annual
$7,200
Cost-Effectiveness
POORQALYs Gained
0.8
ICER
$180,000/QALY
Cost per Responder
$8,181.82
Treatment Outcomes
Primary Outcomes
Hemoglobin A1c (HbA1c)8.5%
-17.6% (-1.5%)
Fasting Plasma Glucose (FPG)200 mg/dL
-30% (-60 mg/dL)
Mean Daily Glucose220 mg/dL
-18.2% (-40 mg/dL)
Incidence of Severe Hypoglycemia0.5 events/patient-year
+100% (+0.5 events/patient-year)
Secondary Benefits
Body Weight90 kg
+2.2% (+2 kg)
Diabetes-Specific Quality of Life (DQOL score)3.0/5.0 (higher is worse)
-10% (-0.3 points)
Glucose Variability (Standard Deviation)45 mg/dL
-22.2% (-10 mg/dL)
Common Side Effects
Hypoglycemia (mild-moderate)
+30%
Weight gain
+8%
Injection site reactions
+2%
Clinical Trial Phases:
Phase 4
2
Lifestyle Modifications (Diet & Exercise)
92% Effectiveness• 90% Confidence• 95% Safety• 7 trials• 2M participants
HIGH EvidenceExcellent ValueDose: 30-60 minutes moderate-intensity exercise 5x/week, calorie-restricted balanced diet
Comparative Safety Scale(Higher is safer)
Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
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Water💧
95
DangerousModerateSafe
Time to Effect
1-4 weeks for glucose, 3-6 months for significant weight loss/remission
Duration
Lifetime
Response Rate
80%
Remission Rate
40%
Number Needed to Treat (NNT)
4
Number Needed to Harm (NNH)
10000
Common Side Effects:
Muscle soreness/injury: 7%
Hypoglycemia (if on medication and diet/exercise not adjusted): 0.5%
Nutritional deficiencies (with poorly managed restrictive diets): 0.1%
Annual Cost of Care
Drug Cost
$0
Monitoring
$425
Side Effects
$20
Total Annual
$445
Cost-Effectiveness
EXCELLENTQALYs Gained
1.75
ICER
$-5,000/QALY
Cost per Remission
$1,112.5
Cost per Responder
$556.25
Treatment Outcomes
Primary Outcomes
HbA1c8.0%
-15% (-1.2%)
Fasting Plasma Glucose180 mg/dL
-19.4% (-35 mg/dL)
Body Weight220 lbs
-7% (-15.4 lbs)
Blood Pressure (Systolic/Diastolic)140/90 mmHg
-5.7% (-8/5 mmHg)
Secondary Benefits
Triglycerides200 mg/dL
-20% (-40 mg/dL)
HDL Cholesterol40 mg/dL
+10% (+4 mg/dL)
Quality of Life (SF-36 Physical Functioning)SF-36 Physical Functioning score: 60/100
+12% (+7.2 points)
Common Side Effects
Muscle soreness/injury
+7%
Hypoglycemia (if on medication and diet/exercise not adjusted)
+0.5%
Nutritional deficiencies (with poorly managed restrictive diets)
+0.1%
3
Semaglutide (GLP-1 Receptor Agonist)
90% Effectiveness• 90% Confidence• 60% Safety• 27 trials• 100K participants
HIGH EvidenceGood ValueDose: Oral: 3-14 mg daily; Injectable: 0.25-2 mg weekly
Comparative Safety Scale(Higher is safer)
Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
60
DangerousModerateSafe
Time to Effect
2-4 weeks for glucose, 2-3 months for full effect
Duration
Lifetime
Response Rate
78%
Remission Rate
10%
Number Needed to Treat (NNT)
4
Number Needed to Harm (NNH)
1000
Common Side Effects:
Nausea: 30%
Vomiting: 10%
Diarrhea: 15%
Constipation: 10%
Pancreatitis: 0.1%
Annual Cost of Care
Drug Cost
$13,000
Monitoring
$450
Side Effects
$100
Total Annual
$13,550
Cost-Effectiveness
GOODQALYs Gained
1
ICER
$80,000/QALY
Cost per Remission
$135,500
Cost per Responder
$17,371.79
Treatment Outcomes
Primary Outcomes
Hemoglobin A1c (HbA1c)8.1 %
-18.5% (-1.5 %)
Body Weight95 kg
-10.5% (-10 kg)
Fasting Plasma Glucose175 mg/dL
-28.6% (-50 mg/dL)
Systolic Blood Pressure138 mmHg
-4.3% (-6 mmHg)
Secondary Benefits
Triglycerides200 mg/dL
-15% (-30 mg/dL)
High-sensitivity C-reactive protein (hs-CRP)3.5 mg/L
-28.6% (-1.0 mg/L)
Quality of Life (EQ-5D VAS Score)70/100
+7.1% (+5 points)
Common Side Effects
Nausea
+30%
Vomiting
+10%
Diarrhea
+15%
Clinical Trial Phases:
Phase 4
4
Empagliflozin (SGLT2 Inhibitor)
89% Effectiveness• 90% Confidence• 60% Safety• 69 trials• 80K participants
HIGH EvidenceGood ValueDose: 10-25 mg daily
Comparative Safety Scale(Higher is safer)
Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
60
DangerousModerateSafe
Time to Effect
Days to 1-2 weeks
Duration
Lifetime
Response Rate
72%
Remission Rate
6%
Number Needed to Treat (NNT)
6
Number Needed to Harm (NNH)
15
Common Side Effects:
Genital mycotic infections: 7%
Urinary tract infections: 4%
Polyuria: 4%
Volume depletion/hypotension: 1.5%
Diabetic ketoacidosis (euglycemic DKA): 0.1%
Annual Cost of Care
Drug Cost
$9,000
Monitoring
$450
Side Effects
$150
Total Annual
$9,600
Cost-Effectiveness
GOODQALYs Gained
1.2
ICER
$70,000/QALY
Cost per Remission
$160,000
Cost per Responder
$13,333.33
Treatment Outcomes
Primary Outcomes
Number of Participants With Hospitalization for Heart Failure (HHF), Broad + Specific Definition
0%
Number of Participants With Hospitalization for Heart Failure (HHF), Broad Definition
0%
Number of Participants With Hospitalization for Heart Failure (HHF), Specific Definition
0%
Number of Participants With All-cause Mortality (ACM)
0%
Number of Participants With Composite Outcome, Including Hospitalization for Heart Failure (HHF) and All Cause Mortality (ACM)
0%
Number of Participants With Composite Outcome, Including Myocardial Infraction (MI), Stroke and All Cause Mortality (ACM)
0%
Number of Participants With Myocardial Infarction (MI)
0%
Number of Participants With Stroke
0%
Number of Patients in Each Category of First Prescription of a Respective Modern Type 2 Diabetes (T2D) Medication According to Prescribing Specialist815 Participants
-70% (-571.0 Participants)
Number of Patients Initiated on a Modern Type 2 Diabetes (T2D) Medication Who Also Received Concomitant T2D Medications at Study Index Date 1 According to Prescribing Specialist
0%
Number of Patients Initiated on a Modern Type 2 Diabetes (T2D) Medication Who Also Received Concomitant Cardiovascular Disease (CVD) and/or Chronic Kidney Disease (CKD) Medication at Study Index Date 1 According to Prescribing Specialist
0%
Baseline Characteristic: Age According to Type 2 Diabetes (T2D) Medication for the Patients Who Were Initiated on T2D Medication by Endocrinologist
0%
Baseline Characteristic: Number of Patients in Each Category of Gender According to Type 2 Diabetes (T2D) Medication for the Patients Who Were Initiated on T2D Medication by Endocrinologist432 Participants
-11% (-49.0 Participants)
Baseline Characteristic: Body Mass Index (BMI) According to Type 2 Diabetes (T2D) Medication for the Patients Who Were Initiated on T2D Medication by Endocrinologist
0%
Baseline Characteristic: Number of Patients in Each Category of Race According to Type 2 Diabetes (T2D) Medication for the Patients Who Were Initiated on T2D Medication by Endocrinologist10 Participants
+7950% (+795.0 Participants)
Baseline Characteristic: Age According to Type 2 Diabetes (T2D) Medication for the Patients Who Were Initiated on T2D Medication by Diabetologist
0%
Baseline Characteristic: Number of Patients in Each Category of Gender According to Type 2 Diabetes (T2D) Medication for the Patients Who Were Initiated on T2D Medication by Diabetologist433 Participants
+48% (+207.0 Participants)
Body Mass Index (BMI) According to Type 2 Diabetes (T2D) Medication for the Patients Who Were Initiated on T2D Medication by Diabetologist
0%
Baseline Characteristic: Number of Patients in Each Category of Race According to Type 2 Diabetes (T2D) Medication for the Patients Who Were Initiated on T2D Medication by Diabetologist3 Participants
+35567% (+1067.0 Participants)
Baseline Characteristic: Age According to Type 2 Diabetes (T2D) Medication for the Patients Who Were Initiated on T2D Medication by Cardiologist
0%
Baseline Characteristic: Number of Patients in Each Category of Gender According to Type 2 Diabetes (T2D) Medication for the Patients Who Were Initiated on T2D Medication by Cardiologist35 Participants
+23% (+8.0 Participants)
Body Mass Index (BMI) According to Type 2 Diabetes (T2D) Medication for the Patients Who Were Initiated on T2D Medication by Cardiologist
0%
Baseline Characteristic: Number of Patients in Each Category of Race According to Type 2 Diabetes (T2D) Medication for the Patients Who Were Initiated on T2D Medication by Cardiologist
0%
Time Since Diagnosis of Type 2 Diabetes (T2D) According to T2D Medication for the Patients Who Were Initiated on T2D Medication by Endocrinologist
0%
Time Since Diagnosis of Type 2 Diabetes (T2D) According to T2D Medication for the Patients Who Were Initiated on T2D Medication by Diabetologist
0%
Time Since Diagnosis of Type 2 Diabetes (T2D) According to T2D Medication for the Patients Who Were Initiated on T2D Medication by Cardiologist
0%
Clinical Parameter Relevant for Type 2 Diabetes (T2D): Percentage of Glycosylated Hemoglobin (HbA1c [%]) According to T2D Medication for the Patients Who Were Initiated on T2D Medication by Endocrinologist
0%
Clinical Parameter Relevant for T2D: Number of Patients in Each Category of Percentage of Glycosylated Hemoglobin (HbA1c) According to T2D Medication for the Patients Who Were Initiated on T2D Medication by Endocrinologist453 Participants
-23% (-104.0 Participants)
Clinical Parameter Relevant for Type 2 Diabetes (T2D): Percentage of Glycosylated Hemoglobin (HbA1c [%]) According to T2D Medication for the Patients Who Were Initiated on T2D Medication by Diabetologist
0%
Clinical Parameter Relevant for Type 2 Diabetes (T2D): Number of Patients in Each Category of Percentage of Glycosylated Hemoglobin (HbA1c) According to T2D Medication for the Patients Who Were Initiated on T2D Medication by Diabetologist642 Participants
-57% (-364.0 Participants)
Clinical Parameter Relevant for Type 2 Diabetes (T2D): Percentage of Glycosylated Hemoglobin (HbA1c [%]) According to T2D Medication for the Patients Who Were Initiated on T2D Medication by Cardiologist
0%
Clinical Parameter Relevant for Type 2 Diabetes (T2D): Number of Patients in Each Category of Percentage of Glycosylated Hemoglobin (HbA1c) According to T2D Medication for the Patients Who Were Initiated on T2D Medication by Cardiologist36 Participants
-61% (-22.0 Participants)
10-year Risk for Fatal Cardiovascular Disease (CVD) According to Type 2 Diabetes (T2D) Medication for the Patients Who Were Initiated on T2D Medication by Endocrinologist
0%
10-year Risk for Fatal Cardiovascular Disease (CVD) According to Type 2 Diabetes (T2D) Medication for the Patients Who Were Initiated on T2D Medication by Diabetologist
0%
10-year Risk for Fatal Cardiovascular Disease (CVD) According to Type 2 Diabetes (T2D) Medication for the Patients Who Were Initiated on T2D Medication by Cardiologist
0%
Number of Patients Per Type of Medical Specialty of Other Physicians Involved in Treatment Decision According to Type 2 Diabetes (T2D) Medication for the Patients Who Were Initiated on T2D Medication by Endocrinologist
0%
Number of Patients Per Type of Medical Specialty of Other Physicians Involved in Treatment Decision According to Type 2 Diabetes (T2D) Medication for the Patients Who Were Initiated on T2D Medication by Diabetologist
0%
Number of Patients Per Type of Medical Specialty of Other Physicians Involved in Treatment Decision According to Type 2 Diabetes (T2D) Medication for the Patients Who Were Initiated on T2D Medication by Cardiologist
0%
Secondary Benefits
Number of Participants With Cardiovascular Mortality (CM)
0%
Number of Participants With Composite Outcome Including Hospitalization for Heart Failure (HHF) and Cardiovascular (CV) Mortality
0%
Number of Participants With 3-point Major Adverse Cardiovascular (CV) Events (MACE), Defined as a Composite Outcome Including Myocardial Infarction (MI), Stroke and Cardiovascular (CV) Mortality
0%
Common Side Effects
Genital mycotic infections
+7%
Urinary tract infections
+4%
Polyuria
+4%
Clinical Trial Phases:
Phase 4
5
Metformin
88% Effectiveness• 95% Confidence• 65% Safety• 1523 trials• 2M participants
HIGH EvidenceExcellent ValueDose: 500-2550 mg daily
Comparative Safety Scale(Higher is safer)
Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
65
DangerousModerateSafe
Time to Effect
1-2 weeks
Duration
Lifetime
Response Rate
75%
Remission Rate
7%
Number Needed to Treat (NNT)
3
Number Needed to Harm (NNH)
10000
Common Side Effects:
Diarrhea: 35%
Nausea/Vomiting: 15%
Abdominal discomfort: 18%
Lactic acidosis: 0.1%
B12 deficiency: 7%
Annual Cost of Care
Drug Cost
$40
Monitoring
$425
Side Effects
$50
Total Annual
$515
Cost-Effectiveness
EXCELLENTQALYs Gained
0.75
ICER
$5,000/QALY
Cost per Remission
$7,357.14
Cost per Responder
$686.67
Treatment Outcomes
Primary Outcomes
HbA1c8.0%
-12.5% (-1.0 %)
Fasting Plasma Glucose180 mg/dL
-22.2% (-40 mg/dL)
Body Weight90 kg
-3.3% (-3 kg)
Secondary Benefits
LDL Cholesterol130 mg/dL
-5.4% (-7 mg/dL)
Triglycerides180 mg/dL
-10% (-18 mg/dL)
Systolic Blood Pressure135 mmHg
-3.7% (-5 mmHg)
Common Side Effects
Diarrhea
+35%
Nausea/Vomiting
+15%
Abdominal discomfort
+18%
Clinical Trial Phases:
Phase 4
6
Glimepiride (Sulfonylurea)
82% Effectiveness• 90% Confidence• 60% Safety• 61 trials• 400K participants
HIGH EvidenceExcellent ValueDose: 1-8 mg daily
Comparative Safety Scale(Higher is safer)
Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
60
DangerousModerateSafe
Time to Effect
Days to 1-2 weeks
Duration
Lifetime
Response Rate
78%
Remission Rate
3%
Number Needed to Treat (NNT)
4
Number Needed to Harm (NNH)
35
Common Side Effects:
Hypoglycemia: 12%
Weight gain: 3%
Nausea/Diarrhea: 3%
Annual Cost of Care
Drug Cost
$75
Monitoring
$450
Side Effects
$100
Total Annual
$625
Cost-Effectiveness
EXCELLENTQALYs Gained
0.7
ICER
$25,000/QALY
Cost per Remission
$20,833.33
Cost per Responder
$801.28
Treatment Outcomes
Primary Outcomes
HbA1c8.5%
-17.6% (-1.5%)
Fasting Plasma Glucose200 mg/dL
-30% (-60 mg/dL)
Postprandial Glucose280 mg/dL
-32.1% (-90 mg/dL)
Secondary Benefits
Body Weight85 kg
+2.35% (+2 kg)
Fructosamine350 µmol/L
-20% (-70 µmol/L)
Hypoglycemic Events (per patient-year)0.5 events/patient-year
+400% (+2.0 events/patient-year)
Common Side Effects
Hypoglycemia
+12%
Weight gain
+3%
Nausea/Diarrhea
+3%
Clinical Trial Phases:
Phase 4
7
Sitagliptin (DPP-4 Inhibitor)
78% Effectiveness• 85% Confidence• 68% Safety• 91 trials• 80K participants
HIGH EvidenceModerate ValueDose: 100 mg daily
Comparative Safety Scale(Higher is safer)
Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
68
DangerousModerateSafe
Time to Effect
1-2 weeks
Duration
Lifetime
Response Rate
68%
Remission Rate
3%
Number Needed to Treat (NNT)
8
Number Needed to Harm (NNH)
10000
Common Side Effects:
Nasopharyngitis: 8%
Headache: 7%
Pancreatitis: 0.1%
Joint pain: 0.1%
Annual Cost of Care
Drug Cost
$5,500
Monitoring
$425
Side Effects
$50
Total Annual
$5,975
Cost-Effectiveness
MODERATEQALYs Gained
0.6
ICER
$120,000/QALY
Cost per Remission
$199,166.67
Cost per Responder
$8,786.76
Treatment Outcomes
Primary Outcomes
Glycated Hemoglobin (HbA1c)8.0%
-8.8% (-0.7%)
Fasting Plasma Glucose170 mg/dL
-14.7% (-25 mg/dL)
2-hour Postprandial Glucose270 mg/dL
-22.2% (-60 mg/dL)
Body Weight90 kg
-0.6% (-0.5 kg)
Secondary Benefits
Systolic Blood Pressure135 mmHg
-1.5% (-2 mmHg)
Diastolic Blood Pressure85 mmHg
-1.2% (-1 mmHg)
Triglycerides180 mg/dL
-5% (-9 mg/dL)
Common Side Effects
Nasopharyngitis
+8%
Headache
+7%
Pancreatitis
+0.1%
Clinical Trial Phases:
Phase 4