Open Access葡萄糖钠协同转运蛋白2抑制剂联合胰岛素对1型成人糖尿病治疗的安全性和有效性:随机对照试验的荟萃分析
Author(s) -
Li Kexin,
Xu Gaosi
Publication year - 2019
Publication title -
journal of diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.949
H-Index - 43
eISSN - 1753-0407
pISSN - 1753-0393
DOI - 10.1111/1753-0407.12890
Subject(s) - medicine , diabetic ketoacidosis , hypoglycemia , diabetes mellitus , randomized controlled trial , dapagliflozin , adverse effect , insulin , cochrane library , type 1 diabetes , glycemic , type 2 diabetes , endocrinology , gastroenterology , pharmacology
Background The safety and efficacy of sodium glucose co‐transporter 2 (SGLT2) inhibitors in a dose‐dependent manner for type 1 diabetes mellitus (T1DM) are unclear. Methods Randomized clinical trials (RCT) were searched from PubMed, EMBASE, the Cochrane Library, Web of Science and ClinicalTrials until August 2018. Results Thirteen RCT with 5397 participants were included. SGLT2 inhibitors were proved to be effective in glycemic control and weight loss in T1DM. In the subgroups of different doses, SGLT2 inhibitors exhibited reductions in glycated haemoglobin, bodyweight, fasting plasma glucose, mean daily glucose, basal insulin dose, bolus insulin dose, estimated glomerular filtration rate and systolic blood pressure, and elevations in the mean amplitude of glucose excursions, and percentage of time in target glucose range in a dose‐dependent manner. Reductions in total insulin dose and urinary glucose excretion were dose‐independent. SGLT2 inhibitors did not induce hypoglycemia, severe hypoglycemia, cardiovascular events, bone fracture and all‐cause mortality, but increased the risk of adverse events (AE), adverse events related to the drug treatment, infections, diabetic ketoacidosis (DKA) and renal disease correlated with dosage. Conclusions SGLT2 inhibitors in high and moderate doses can achieve a better outcome on efficacy, but may induce a higher risk of adverse events, especially DKA.