Factors Influencing the Prescription of First-Line Treatment for Type 2 Diabetes Mellitus: A Systematic Review

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

First of all, authors have to remove plagiarism at this high percentage not tolerable. The second major mistake is the methodology and selection of papers which should be included in the systematic review. A random selection of papers can not bring any relevant conclusion or scientific value. However, the topic is very old; there is a complete lack of novelty. Structurally, the paper is very weak and needs major improvement. There is a complete lack of figures or charts. Given tables are difficult for easy following. Therefore, I can not see this can be easily improved by one revision.

Comments on the Quality of English Language

The paper needs English language editing.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

In this systematic review the authors discuss the factors influencing the choice of first-line treatment prescription for type 2 diabetes mellitus.  Following a search strategy, 30 studies were included in the review.

Comments:

 Abstract: “Background” and “Methods” sections of the abstract are big and could be shortened. For example, exclusion criteria are part of the main text and it is not necessary to be part of the abstract too. The same stands for PROSPERO registration number. In contrast, the “result” section of the abstract could be enriched with more information. For example, the authors state that “Initial metformin prescription was strongly associated with the age of individuals with diabetes, glycated haemoglobin levels, body mass index, and renal complications” but it is not clear if the association was positive or negative (e.g. increased or decreased age was associated with metformin?). On the other hand, it is not necessary to include in the abstract the results of a certain study. As a result, the sentence “For example, one study reported that individuals with renal disease had lower odds (OR 37 0.14; 95% CI, 0.05-0.40) of starting metformin than other antidiabetic agents” could be removed of the abstract which should generally summarize the results.

Methods:

The authors state that the literature search was conducted in 2023 (two years before). It could be useful if the authors could update the literature search for studies that could possible fulfill the inclusion criteria.

Results and Conclusion

 The authors mention in several parts of the manuscript and highlight it as a main finding of the study that there is a discrepancy between clinical practice and guidelines. However, it is not clear which results have led the authors to this conclusion.

Discussion

It could be useful if the authors could further discuss the results and provide possible explanations for discrepancies between studies or “unexpected” results.

Author Response

Please see the attachment. 

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

I thoroughly enjoyed this review and few minor points for improvement. Kindly see attached word document.

Comments for author File: Comments.pdf

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 2 Report

Comments and Suggestions for Authors

The revised version of the manuscript has been improved.

Author Response

Comments 1: "The revised version of the manuscript has been improved."

Responde 1: We sincerely thank the reviewer for the positive feedback and for acknowledging the improvements made in the revised version of the manuscript. We appreciate the time and consideration given to our work.

Should any additional clarifications or modifications be required, we remain at your disposal.