SGLT2 inhibitors as adjunct therapy to insulin in type 1 diabetes: Meta analysis / 解放军医学杂志

ABSTRACT

Objective To evaluate the efficacy and safety of sodium glucose co-transporter-2 (SGLT-2) inhibitors as adjunct therapy to insulin in type 1 diabetes (T1DM). Methods The PubMed, The Cochrane Library, EMbase, CENTRRAI, CBM, CNKI, VIP and WangFang database were searched from inception to April 5, 2016 for systematic reviews, references screen was performed manually. The trials of SGLT2 inhibitors versus placebo add to insulin carried out in patients with T1DM were collected, and their bias risk was assessed and meta-analysis was conducted by using RevMan 5.3 software. Results Four randomized control trials (RCTs) were yielded for meta-analysis, including 529 patients. Compared with control group, SGLT2 inhibitors as adjunct therapy to insulin significantly reduced fasting plasma glucose (FPG) [weighted mean difference (WMD)= –0.65mmol/L, 95% confidence interval (CI)=–1.30 to –0.08, P<0.05], glycated hemoglobin A1C (HbA1c) (WMD=–0.37%, 95%CI= –0.54 to –0.20, P<0.00001), body weight (WMD=–2.54kg, 95%CI=–3.48 to –1.60, P<0.0001) and total daily insulin dose (WMD= –6.23IU, 95% CI=–8.05 to –4.40, P<0.0001), but the total adverse events (AEs), hypoglycemia, genital and urinary infections showed no significant difference. Conclusions Based on current studies, SGLT-2 inhibitors are effective as adjunct therapy to insulin in T1DM, may improve glycemic control, reduce body weight and total daily insulin dose without increase of total AEs, hypoglycemia, and genital and urinary infections.