Abstract:
OBJECTIVE:Sodium-glucose co-transporter-2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) are now considered as key players in the treatment of type 2 diabetes mellitus (T2DM). The purpose of this meta-analysis was to provide precise effect estimates regarding the safety and efficacy of the addition of a GLP-1RA on top of SGLT-2i treatment. RESEARCH DESIGN AND METHODS:PubMed and CENTRAL, along with grey literature sources, were searched from their inception to May 2019 for randomized controlled trials (RCTs) with a duration ≥ 12 weeks, evaluating the safety and efficacy of addition of a GLP-1RA on a SGLT-2i compared to SGLT-2i alone in patients with T2DM. We also used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess the credibility of our summary estimates. RESULTS:We identified three eligible RCTs, pooling data retrieved from 1,042 patients with T2DM in total. Administration of the maximum dose of a GLP-1RA on top of SGLT-2i treatment compared to SGLT-2i alone resulted in significant decrease in HbA1c by 0.91% (95% CI; -1.41 to -0.42) [GRADE: moderate], in body weight by 1.95 kg (95% CI; -3.83 to -0.07) [GRADE: moderate], in fasting plasma glucose by 1.53 mmol/L (95% CI; -2.17 to -0.88) [GRADE: moderate] and in systolic blood pressure levels by 3.64 mm Hg (95% CI -6.24 to -1.03). No significant effects on lipid profile and diastolic blood pressure were demonstrated. A significant increase in the risk for any hypoglycemia (RR: 2.62, 95% CI; 1.15-5.96, I2 = 33%) [GRADE: moderate] and for nausea (RR: 3.21, 95% CI; 1.36-7.54, I2 = 63%) [GRADE: moderate] and a non-significant increase in the risk for diarrhoea (RR: 1.64, 95% CI; 0.98-2.75, I2 = 0%) [GRADE: low] were documented. No other safety issues were identified. CONCLUSIONS:This meta-analysis suggests that a GLP-1RA/SGLT-2i combination, if tolerated, exerts significant beneficial effects on glycemic control and body weight loss, however increasing the risk for any hypoglycemia and gastrointestinal adverse events.
journal_name
Diabetes Res Clin Practjournal_title
Diabetes research and clinical practiceauthors
Patoulias D,Stavropoulos K,Imprialos K,Katsimardou A,Kalogirou MS,Koutsampasopoulos K,Zografou I,Papadopoulos C,Karagiannis A,Doumas Mdoi
10.1016/j.diabres.2019.107927subject
Has Abstractpub_date
2019-12-01 00:00:00pages
107927eissn
0168-8227issn
1872-8227pii
S0168-8227(19)31120-9journal_volume
158pub_type
杂志文章,meta分析abstract:AIMS:The objective of the present analysis was to evaluate and quantify the risk for gestational diabetes mellitus (GDM) according to maternal age. METHODS:Three electronic databases were searched for publications from inception to July 2018. Odds ratio (OR) and 95% confidence interval (95% CI) were calculated. A dose...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章,meta分析
doi:10.1016/j.diabres.2020.108044
更新日期:2020-04-01 00:00:00
abstract::Coated-platelet levels were quantified in 58 people with Type 1 diabetes, 90 with Type 2 diabetes, and 54 non-diabetic controls. In diabetes high coated-platelet levels were related to smoking and glucose control drugs, but not to glycaemia or other drugs. Prospective studies should evaluate coated-platelets and compl...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2008.04.004
更新日期:2008-08-01 00:00:00
abstract::Recent studies have shown both association and linkage between a Gly40-Ser mutation in the glucagon receptor gene and NIDDM in French patients with familial NIDDM. This mutation was present in heterozygous form in 4.6% of diabetic probands but only 1% of the French population, suggesting that it was an important risk ...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/0168-8227(96)01284-3
更新日期:1996-07-01 00:00:00
abstract:BACKGROUND:The role of chronic inflammation initiated by persistent hyperglycemia in podocyte injury has attracted increasing attention. The advanced glycation end products (RAGE) receptor- nuclear factor-kappa B (NF-кB) signaling pathway is involved in the occurrence of inflammation. We speculate that treatment with h...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2019.05.034
更新日期:2019-10-01 00:00:00
abstract:AIMS:The aim of this study was to investigate whether the polymorphism of DDAH2 is associated with type 2 diabetes and hypertension in Korean population. METHODS:Total 605 subjects were included in this study: 403 patients with type 2 diabetes and 202 non-diabetic control subjects. The SNP rs805304 and rs2272592 in DD...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2012.04.015
更新日期:2012-10-01 00:00:00
abstract:AIMS:The spermatogenesis failure is reported as the main complication for diabetes and the moderate-intensity exercise (EX) is shown to ameliorate the diabetes-induced impairments both at spermatogenesis and sperm levels. Thus, the current study was done to investigate the possible effect of EX in the sole and simultan...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2020.108332
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:High sensitivity C-reactive protein (hsCRP) is more sensitive than standard C-reactive protein (CRP) assay in evaluating the risk of coronary heart disease and other atherosclerotic events. By this time, there are several reports that type 2 diabetic subjects have higher serum levels of hsCRP than those of n...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2004.05.009
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVE:To determine if uncooked cornstarch, as part of the evening snack, can avert nocturnal hypoglycemia in type 1 diabetes. RESEARCH DESIGN AND METHODS:Fifty-one campers and counselors at the American Diabetes Association Camp in San Bernardino, CA were randomly assigned to receive 5 g of uncooked cornstarch as ...
journal_title:Diabetes research and clinical practice
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0168-8227(95)01192-7
更新日期:1995-12-01 00:00:00
abstract::We describe here four male patients with long-term and poorly controlled type 2 diabetes mellitus. They shared many common characteristic complications, such as severe autonomic neuropathy, proliferative retinopathy and normocytic normochromic anemia without progressive renal failure and macroangiopathy. They also sho...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2005.04.003
更新日期:2005-12-01 00:00:00
abstract:AIMS:The circadian rhythm and immune system are thought to be associated with the pathological state of diabetes. The aim of this study was to examine the correlation of circadian rhythm disturbance including sleep disturbance with the immune state in patients with type 2 diabetes compared to healthy controls. METHODS...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2009.07.001
更新日期:2009-09-01 00:00:00
abstract::The relative height at the onset of insulin-dependent diabetes mellitus was recorded in 340 cases from Japan and 191 cases from Pittsburgh, U.S.A. In Pittsburgh, the children diagnosed after puberty were shorter than normal whereas those diagnosed prior to puberty were much taller than normal. However, in Japan, there...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/0168-8227(89)90026-0
更新日期:1989-04-01 00:00:00
abstract:AIMS:To enhance the universal coverage of quality diabetes care and overcome disparities in care among different care-provider levels by changing the diabetes care system in Changhua, Taiwan. METHODS:The Changhua Diabetes Shared Care program's second stage commenced in 2004. Two levels of diabetes care were proposed t...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章,多中心研究
doi:10.1016/S0168-8227(14)70736-3
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:This study was conducted to assess the adverse effects of diabetic nephropathy on cardiovascular autonomic neuropathy (CAN) in South Indian Type 2 diabetic patients. METHODS:Comparison was made between Type 2 diabetic patients with nephropathy (group 1, n=25), Type 2 diabetic patients without nephropathy (gr...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/s0168-8227(00)00127-3
更新日期:2000-06-01 00:00:00
abstract:AIM:The study aims to investigate the gene expression profiling of insulin signaling pathway and mitochondrial biogenesis and function in the skeletal muscle of KK mice. METHODS:KK mice were divided into the following groups: KK control group, basal medium (M199) only; KK fibroblast group, with human fibroblast transp...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2013.08.006
更新日期:2013-10-01 00:00:00
abstract:AIM:This study aimed to determine the prevalence of gestational diabetes mellitus (GDM) among women attending public health centers in Rwanda using the World Health Organization (WHO) 2013 diagnostic criteria. METHODS:A cross-sectional analysis was performed on 281 pregnant women attending antenatal care at urban and ...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2019.03.035
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:Islet autoimmunity, age at onset and time to insulin treatment are often used to define subgroups of diabetes. However, the latter criterion is not clinical useful. Here, we examined whether an unbiased stratification of diabetes according to age at onset, fasting C-peptide and GAD autoantibodies (GADab) defi...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2017.09.014
更新日期:2017-12-01 00:00:00
abstract::This retrospective study aimed to characterize comorbidities and associated with mortality among hospitalized adults with Covid-19 managed as perthe Saudi Ministry of Health protocol in a specialized tertiary hospital in Riyadh, Saudi Arabia. Medical records of 300 adult patients with PCR-confirmed SARS-CoV2 infection...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2020.108538
更新日期:2020-11-12 00:00:00
abstract::Glucagon-like peptide-1 (GLP-1) (1-37) and the fraction derived from it, GLP-1 (7-36 amide), are peptides encoded by the preproglucagon gene and possibly co-secreted with enteroglucagon. When added at a 25-nM concentration, GLP-1 (7-36 amide) decreased the release of glucagon from the perfused rat pancreas from 68.5 +...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/s0168-8227(88)80063-9
更新日期:1988-10-14 00:00:00
abstract:UNLABELLED:Over 1 year, a survey on contraception and obstetric history was performed on a cohort of 667 Caucasian fertile diabetic women (446, type 1 and 201, type 2) living in Italy. RESULTS:Of these women, 30.4% used hormonal contraceptives, 12.0% intra-uterine device (IUD), 10.7% declared they used no contraceptio...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2004.07.020
更新日期:2005-03-01 00:00:00
abstract::Insulin resistance is a hallmark of type 2 diabetes and obesity while the mechanism remains unclear. Current therapy to treat type 2 diabetes is metformin, the 5'-monophosphate-activated protein kinase (AMPK) activator, owing to the ability to augment peripheral glucose uptake. However, metformin also displays limitat...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章,评审
doi:10.1016/j.diabres.2017.10.004
更新日期:2019-10-01 00:00:00
abstract::Using a database of patients with type 1 (n=1675) and type 2 (n=2259) diabetes diagnosed before the age of 30 years at the Diabetes Center, Tokyo Women's Medical University (TWMU), in which such Japanese patients have been registered at the time of first visit since the 1960s, we performed a hospital-based study over ...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2008.06.021
更新日期:2008-10-01 00:00:00
abstract:AIMS:To develop a risk "engine" or calculator, integrating the risks of hyperglycemia, maternal BMI and other basic demographic data commonly available at the time of the pregnancy oral glucose tolerance test (OGTT), to predict an individual's absolute risk of specific adverse pregnancy outcomes. METHODS:Data from the...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章,评审
doi:10.1016/j.diabres.2018.02.036
更新日期:2018-05-01 00:00:00
abstract::HLA-DQA11 and DQB1 alleles coding for arginine (R) in position 52, and an amino acid other than aspartic acid (ND) in position 57, respectively, are strong genetic markers for IDDM in Caucasians. However, their contribution to the occurrence of the disease in Asian populations is less clear. As part of the WHO DiaMond...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/s0168-8227(96)90018-2
更新日期:1996-10-01 00:00:00
abstract::Knowledge about the current status of diabetes management is indispensable for the improvement of diabetes management. We performed a survey to investigate the current trend of diabetes management in elderly Koreans, at eight hospitals located throughout the country. A total of 539 patients with type 2 diabetes older ...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章,多中心研究
doi:10.1016/j.diabres.2007.01.047
更新日期:2007-09-01 00:00:00
abstract::In the present study, we recruited 124 patients with type 2 diabetes, among which 22 had a history of cardiovascular disease (CVD). The study demonstrated that compared with type 2 diabetes without CVD, those with CVD had remarkably higher levels of angiopoietin-like protein 8 (ANGPTL8). Moreover, the close relationsh...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2016.08.017
更新日期:2016-10-01 00:00:00
abstract::Fibroblast growth factor 21 (FGF21) has been identified as a novel metabolic regulator. This cross-sectional study was performed to clarify how serum FGF21 levels were associated with clinical parameters in Japanese subjects with type 2 diabetes (n=139). Anthropometric and blood biochemical parameters, uses of drugs f...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2010.03.019
更新日期:2010-07-01 00:00:00
abstract::Type 2 diabetes mellitus (T2DM) is characterised by beta-cell failure in the setting of obesity-related insulin resistance. Progressive beta-cell dysfunction determines the course of the disease, regardless of the treatment used. There is mounting evidence that chronically elevated circulating levels of glucose and fa...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章,评审
doi:10.1016/S0168-8227(11)70012-2
更新日期:2011-08-01 00:00:00
abstract:AIM:Gastric emptying is a major determinant of the glycaemic response to carbohydrate and is frequently abnormal in type 2 diabetes (T2DM). There is little information about how chronic glycaemic control affects gastric emptying in T2DM. We evaluated gastric emptying of a 75 g glucose drink in community-based patients ...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2020.108610
更新日期:2020-12-07 00:00:00
abstract::The results of various studies suggest that hypertriglyceridaemia is associated with an increased risk of coronary artery disease. It is unclear, however, which particular triglyceride (TG)-rich lipoproteins contribute to the risk. Different types of TG-rich lipoprotein differ in function, composition, size and densit...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章,评审
doi:10.1016/s0168-8227(98)00040-0
更新日期:1998-07-01 00:00:00
abstract:AIMS:We estimated the number of live births worldwide and by IDF Region who developed hyperglycaemia in pregnancy in 2013, including total diabetes in pregnancy (known and previously undiagnosed diabetes) and gestational diabetes. METHODS:Studies reporting prevalence of hyperglycaemia first-detected in pregnancy (form...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2013.11.003
更新日期:2014-02-01 00:00:00