4.3 Article

Effects of sodium-glucose cotransporter 2 inhibitors in addition to insulin therapy on cardiovascular risk factors in type 2 diabetes patients: A meta-analysis of randomized controlled trials

期刊

JOURNAL OF DIABETES INVESTIGATION
卷 10, 期 2, 页码 446-457

出版社

WILEY
DOI: 10.1111/jdi.12876

关键词

Cardiovascular risk factors; Meta-analysis; Sodium-glucose cotransporter 2 inhibitor

资金

  1. National Natural Science Foundation of China [31570819]
  2. Science and Technology Projects of Liaoning Province [2015225024]
  3. Local Development Foundation of Science and Technology [2016007024]

向作者/读者索取更多资源

Aims/Introduction In the present meta-analysis, we aimed to determine the effects of sodium-glucose cotransporter 2 inhibitor (SGLT-2i) in addition to insulin therapy on cardiovascular risk factors in type 2 diabetes patients. Materials and Methods Randomized controlled trials were identified by searching the PubMed, Embase and Cochrane Library databases published before September 2017. The intervention group received SGLT-2i as add-on treatment to insulin therapy, and the control group received placebos in addition to insulin. We assessed pooled data, including weighted mean differences and 95% confidence intervals (CIs) using a random-effects model. Results A total of 10 randomized controlled trials (n = 5,159) were eligible. The weighted mean differences for systolic blood pressure and diastolic blood pressure were -3.17 mmHg (95% CI -4.53, -1.80, I-2 = 0%) and -1.60 mmHg (95% CI -2.52, -0.69, I-2 = 0%) in the intervention groups. Glycosylated hemoglobin, fasting plasma glucose, postprandial glucose and daily insulin were also lower in the intervention groups, with relative weighted mean differences of -0.49% (95% CI -0.71, -0.28%, I-2 = 92%), -1.10 mmol/L (95% CI -1.69, -0.51 mmol/L, I-2 = 84%), -3.63 mmol/L (95% CI -4.36, -2.89, I-2 = 0%) and -5.42 IU/day (95% CI -8.12, -2.72, I-2 = 93%). The transformations of uric acid and bodyweight were -26.16 mu mol/L (95% CI -42.14, -10.17, I-2 = 80%) and -2.13 kg (95% CI -2.66, -1.60, I-2 = 83%). The relative risk of hypoglycemia was 1.09 (95% CI 1.02, 1.17, P < 0.01). The relative risks of urinary tract and genital infection were 1.29 (95% CI 1.03, 1.62, P = 0.03) and 5.25 (95% CI 3.55, 7.74, P < 0.01). Conclusions The results showed that in the intervention group, greater reductions were achieved for blood pressure, glucose control, uric acid and bodyweight. This treatment regimen might therefore provide beneficial effects on the occurrence and development of cardiovascular events.

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