This disclaimer and any questions or matters of any nature arising from or relating to the content or use (or misuse) of this document will be governed by and interpreted in accordance with the laws of the Province of Ontario and the laws of Canada applicable therein, and all proceedings shall be subject to the exclusive jurisdiction of the courts of the Province of Ontario, Canada. [...] The amount and quality of evidence was insufficient to draw conclusions regarding the relative efficacy of the add-on, partial-switch, and switch regimens in the initiation of insulin. [...] Active and non-active randomized controlled trials (RCTs) published in English were included if they were at least four weeks in duration and compared one or more relevant drugs in any of the following scenarios: addition of a third agent while continuing metformin and sulfonylurea combination therapy (add-on therapy) initiation of third-line therapy upon discontinuation of metformin or sulfon [...] This review used a random-effects model for the reference case of all pairwise and MTC meta-analyses, as there was a degree of heterogeneity across studies in trial duration, dosing of agents, baseline characteristics, and treatment history of the included patients. [...] The mean duration of diabetes at baseline ranged from 3.5 years28 to 12.7 years.17 The mean baseline A1C of trial subjects ranged from 8.1%20,22,28 to 11.3%.12,21 Regarding gender, the percentage of males ranged from 27.6%21 to 75.4%.20 The mean age of participants at baseline ranged from 51.2 years27 to 69.4 years13 (Table 5).