Sodium-glucose co-transporter 2 inhibitors in addition to insulin therapy for management of type 2 diabetes mellitus: A meta-analysis of randomized controlled trials.
Given inconsistent trial results of sodium-glucose cotransporter 2 (SGLT2) inhibitors in addition to insulin therapy for treating type 2 diabetes mellitus (T2DM), a meta-analysis was performed to evaluate the efficacy and safety of this combination for T2DM by searching available randomized trials from PubMed, Embase, CENTRAL and ClinicalTrials.gov. Our meta-analysis included seven eligible placebo-controlled trials involving 4235 patients. Compared with placebo, SGLT2 inhibitor treatment was significantly associated with a mean reduction in HbA1c of -0.56%, fasting plasma glucose of -0.95 mmol/L, body weight of -2.63 kg and insulin dose of -8.79 IU, but an increased risk of drug-related adverse events by 36%, urinary tract infections by 29% and genital infections by 357%. No significant increase was observed in risk of overall adverse events [risk ratio (RR), 1.00], serious adverse events (RR, 0.90), adverse events leading to discontinuation (RR, 1.16), hypoglycaemia events (RR, 1.07) and severe hypoglycaemia events (RR, 1.24). No diabetic ketoacidosis events were reported. Further studies are needed to establish optimal combination type and dose.
Department of Pharmacy, Peking University Third Hospital, Beijing, China.|Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana.|Center for Pharmacoepidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana.
Huilin
H
Tang
Department of Endocrinology and Metabolism, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an Jiaotong University Health Science Center, Xi'an, China.
Wei
W
Cui
Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Dandan
D
Li
Department of Pharmacy Administration and Clinical Pharmacy, Peking University Health Science Center, Beijing, China.
Tiansheng
T
Wang
Division of Nephrology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
Jingjing
J
Zhang
Department of Pharmacy, Peking University Third Hospital, Beijing, China.
Suodi
S
Zhai
Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana.|Center for Pharmacoepidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana.
Yiqing
Y
Song
D001559:Benzhydryl Compounds / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D001835:Body Weight; D000068896:Canagliflozin / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism; D004359:Drug Therapy, Combination; D005960:Glucosides / Q000627:therapeutic use; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D016017:Odds Ratio; D016032:Randomized Controlled Trials as Topic; D060737:Reproductive Tract Infections / Q000139:chemically induced; D000077203:Sodium-Glucose Transporter 2 Inhibitors; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000139:chemically induced; D015431:Weight Loss
D001559:Benzhydryl Compounds; D001786:Blood Glucose; D000068896:Canagliflozin; D005960:Glucosides; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D000077203:Sodium-Glucose Transporter 2 Inhibitors; C517652:hemoglobin A1c protein, human; C529054:dapagliflozin; C570240:empagliflozin

SGLT2 inhibitor; insulin therapy; meta-analysis; type 2 diabetes