title: The efficacy and safety of SGLT2 inhibitors for adjunctive treatment of type 1 diabetes: a systematic review and meta-analysis.
abstract: To assess the efficacy and safety of the SGLT-2 inhibitors as adjunct therapy to insulin in T1DM, clinical trials indexed in PubMed, Cochrane Library, EMbase from inception through April 5, 2016. A meta-analysis was conducted on trials of SGLT-2 inhibitors in patients with T1DM on insulin therapy using RevMan 5.3 software. Of the 371 articles identified, ten met eligibility criteria. Seven clinical trials including four randomized controlled trials and 581 patients were included. Compared with the control group, SGLT-2 inhibitors group had significantly reduced fasting plasma glucose by 0.69 mmol/L [1.32; 0.07], glycosylated hemoglobin A1C by 0.37% [0.54; 0.20], body weight by 2.54 kg [3.48; 1.60] and total daily insulin dose by 6.22 IU [8.04; 4.40]. The total incidence of adverse events (AEs), hypoglycemia, and genital and urinary infections were also similar to placebo, while an increased incidence of diabetic ketoacidosis (DKA) (n = 16) was seen in SGLT-2 inhibitors group. The present study demonstrates that SGLT-2 inhibitors are effective as adjunct therapy to insulin in T1DM, heralding improved glycemic control, reduced body weight and total daily insulin dose without an increase in total AEs, hypoglycemia, or genital and urinary infections. However, the risk of DKA should be carefully monitored in future clinical trials.
authors.affiliation: Department of Endocrinology, Affiliated Hospital of Southwest Medical College, Luzhou, Sichuan 646000, China.
authors.forename: Jiao
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Endocrinology, Affiliated Hospital of Southwest Medical College, Luzhou, Sichuan 646000, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Fan
authors.affiliation: Department of Endocrinology, Affiliated Hospital of Southwest Medical College, Luzhou, Sichuan 646000, China.
authors.forename: J Y
authors.initials: JY
authors.lastname: Wang
authors.affiliation: Department of Endocrinology, Affiliated Hospital of Southwest Medical College, Luzhou, Sichuan 646000, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Long
authors.affiliation: Department of Endocrinology, Affiliated Hospital of Southwest Medical College, Luzhou, Sichuan 646000, China.
authors.forename: C L
authors.initials: CL
authors.lastname: Gao
authors.affiliation: Joslin Diabetes Center, Boston, MA, USA.|Beth Israel Deaconess Medical Center, Boston, MA, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.
authors.forename: R C
authors.initials: RC
authors.lastname: Stanton
authors.affiliation: Department of Endocrinology, Affiliated Hospital of Southwest Medical College, Luzhou, Sichuan 646000, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Xu
mesh_terms: D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000378:metabolism; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D051297:Sodium-Glucose Transporter 2; D000077203:Sodium-Glucose Transporter 2 Inhibitors; D014552:Urinary Tract Infections / Q000139:chemically induced / Q000378:metabolism
chemical_list: D007004:Hypoglycemic Agents; C089180:SLC5A2 protein, human; D051297:Sodium-Glucose Transporter 2; D000077203:Sodium-Glucose Transporter 2 Inhibitors