Dipeptidyl peptidase-4 inhibitors as add-on therapy to insulin in patients with type 2 diabetes mellitus: a meta-analysis of randomized controlled trials

Na Wang,1 Tao Yang,2 Jie Li,2 Xianfeng Zhang21Department of Endocrinology, The Affiliated Hospital of Jining Medical University, Jining 272000, People’s Republic of China; 2The 4th Department of Psychiatry, Jining Psychiatric Hospital, Jining 272000, People’s Republic of ChinaCor...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Wang N, Yang T, Li J, Zhang X
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	dipeptidyl peptidase-4 inhibitors insulin add-on therapy diabetes mellitus meta-analysis Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/2a8eca7cace44359a6133f540053f533
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:2a8eca7cace44359a6133f540053f533
record_format	dspace
spelling	oai:doaj.org-article:2a8eca7cace44359a6133f540053f5332021-12-02T08:22:38ZDipeptidyl peptidase-4 inhibitors as add-on therapy to insulin in patients with type 2 diabetes mellitus: a meta-analysis of randomized controlled trials1178-7007https://doaj.org/article/2a8eca7cace44359a6133f540053f5332019-08-01T00:00:00Zhttps://www.dovepress.com/dipeptidyl-peptidase-4-inhibitors-as-add-on-therapy-to-insulin-in-pati-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Na Wang,1 Tao Yang,2 Jie Li,2 Xianfeng Zhang21Department of Endocrinology, The Affiliated Hospital of Jining Medical University, Jining 272000, People’s Republic of China; 2The 4th Department of Psychiatry, Jining Psychiatric Hospital, Jining 272000, People’s Republic of ChinaCorrespondence: Na WangDepartment of Endocrinology, The Affiliated Hospital of Jining Medical University, No. 89 Guhuai Road, Jining 272000, People’s Republic of ChinaTel +86 0 537 290 3399Fax +86 0 537 290 3399Email wangna22838@126.comPurpose: Addition of the dipeptidyl peptidase-4 (DPP4) inhibitors to insulin in patients with type 2 diabetes mellitus (T2DM) may achieve better glycemic control. However, results of pilot randomized controlled trials (RCTs) are inconsistent. We aimed to perform a meta-analysis of RCTs to evaluate efficacy and safety of DPP4 inhibitors compared with placebo/no treatment as add-on therapy to insulin in T2DM patients.Materials and methods: Relevant studies were identified via a search of PubMed, Cochrane Library, and Embase databases. A fixed or random effect model was applied according to the heterogeneity.Results: Overall, 22 RCTs with 6,957 T2DM patients were included. Addition of DPP4 inhibitors to insulin was associated with significantly reduced HbA1c as compared with controls (weighed mean difference [WMD]: −0.54%, p<0.001). The benefits of DPP4 inhibitors as add-on therapy on HbA1c were independent of study design, follow-up duration, categories of DPP4 inhibitors used, and using of fixed/adjustable insulin doses as indicated by predefined subgroup analyses. Moreover, addition of DPP4 inhibitors to insulin was associated with significantly reduced fasting blood glucose (WMD: −0.47mmol/L, p<0.001), postprandial glucose at 2 hrs (WMD: −2.03 mmol/L, p<0.001), and daily dose of insulin (WMD: −2.73U/d, p<0.001), while body weight (WMD: 0.02 g, p=0.81) or risk of symptomatic hypoglycemia (risk ratio: 0.92, p=0.37) were not affected.Conclusions: Addition of DPP4 inhibitors to insulin significantly improved the glycemic control in T2DM patients without further increasing the risk of weight gain and hypoglycemia.Keywords: dipeptidyl peptidase-4 inhibitors, insulin, add-on therapy, diabetes mellitus, meta-analysisWang NYang TLi JZhang XDove Medical Pressarticledipeptidyl peptidase-4 inhibitorsinsulinadd-on therapydiabetes mellitusmeta-analysisSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 12, Pp 1513-1526 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	dipeptidyl peptidase-4 inhibitors insulin add-on therapy diabetes mellitus meta-analysis Specialties of internal medicine RC581-951
spellingShingle	dipeptidyl peptidase-4 inhibitors insulin add-on therapy diabetes mellitus meta-analysis Specialties of internal medicine RC581-951 Wang N Yang T Li J Zhang X Dipeptidyl peptidase-4 inhibitors as add-on therapy to insulin in patients with type 2 diabetes mellitus: a meta-analysis of randomized controlled trials
description	Na Wang,1 Tao Yang,2 Jie Li,2 Xianfeng Zhang21Department of Endocrinology, The Affiliated Hospital of Jining Medical University, Jining 272000, People’s Republic of China; 2The 4th Department of Psychiatry, Jining Psychiatric Hospital, Jining 272000, People’s Republic of ChinaCorrespondence: Na WangDepartment of Endocrinology, The Affiliated Hospital of Jining Medical University, No. 89 Guhuai Road, Jining 272000, People’s Republic of ChinaTel +86 0 537 290 3399Fax +86 0 537 290 3399Email wangna22838@126.comPurpose: Addition of the dipeptidyl peptidase-4 (DPP4) inhibitors to insulin in patients with type 2 diabetes mellitus (T2DM) may achieve better glycemic control. However, results of pilot randomized controlled trials (RCTs) are inconsistent. We aimed to perform a meta-analysis of RCTs to evaluate efficacy and safety of DPP4 inhibitors compared with placebo/no treatment as add-on therapy to insulin in T2DM patients.Materials and methods: Relevant studies were identified via a search of PubMed, Cochrane Library, and Embase databases. A fixed or random effect model was applied according to the heterogeneity.Results: Overall, 22 RCTs with 6,957 T2DM patients were included. Addition of DPP4 inhibitors to insulin was associated with significantly reduced HbA1c as compared with controls (weighed mean difference [WMD]: −0.54%, p<0.001). The benefits of DPP4 inhibitors as add-on therapy on HbA1c were independent of study design, follow-up duration, categories of DPP4 inhibitors used, and using of fixed/adjustable insulin doses as indicated by predefined subgroup analyses. Moreover, addition of DPP4 inhibitors to insulin was associated with significantly reduced fasting blood glucose (WMD: −0.47mmol/L, p<0.001), postprandial glucose at 2 hrs (WMD: −2.03 mmol/L, p<0.001), and daily dose of insulin (WMD: −2.73U/d, p<0.001), while body weight (WMD: 0.02 g, p=0.81) or risk of symptomatic hypoglycemia (risk ratio: 0.92, p=0.37) were not affected.Conclusions: Addition of DPP4 inhibitors to insulin significantly improved the glycemic control in T2DM patients without further increasing the risk of weight gain and hypoglycemia.Keywords: dipeptidyl peptidase-4 inhibitors, insulin, add-on therapy, diabetes mellitus, meta-analysis
format	article
author	Wang N Yang T Li J Zhang X
author_facet	Wang N Yang T Li J Zhang X
author_sort	Wang N
title	Dipeptidyl peptidase-4 inhibitors as add-on therapy to insulin in patients with type 2 diabetes mellitus: a meta-analysis of randomized controlled trials
title_short	Dipeptidyl peptidase-4 inhibitors as add-on therapy to insulin in patients with type 2 diabetes mellitus: a meta-analysis of randomized controlled trials
title_full	Dipeptidyl peptidase-4 inhibitors as add-on therapy to insulin in patients with type 2 diabetes mellitus: a meta-analysis of randomized controlled trials
title_fullStr	Dipeptidyl peptidase-4 inhibitors as add-on therapy to insulin in patients with type 2 diabetes mellitus: a meta-analysis of randomized controlled trials
title_full_unstemmed	Dipeptidyl peptidase-4 inhibitors as add-on therapy to insulin in patients with type 2 diabetes mellitus: a meta-analysis of randomized controlled trials
title_sort	dipeptidyl peptidase-4 inhibitors as add-on therapy to insulin in patients with type 2 diabetes mellitus: a meta-analysis of randomized controlled trials
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/2a8eca7cace44359a6133f540053f533
work_keys_str_mv	AT wangn dipeptidylpeptidase4inhibitorsasaddontherapytoinsulininpatientswithtype2diabetesmellitusametaanalysisofrandomizedcontrolledtrials AT yangt dipeptidylpeptidase4inhibitorsasaddontherapytoinsulininpatientswithtype2diabetesmellitusametaanalysisofrandomizedcontrolledtrials AT lij dipeptidylpeptidase4inhibitorsasaddontherapytoinsulininpatientswithtype2diabetesmellitusametaanalysisofrandomizedcontrolledtrials AT zhangx dipeptidylpeptidase4inhibitorsasaddontherapytoinsulininpatientswithtype2diabetesmellitusametaanalysisofrandomizedcontrolledtrials
_version_	1718398535124123648

Dipeptidyl peptidase-4 inhibitors as add-on therapy to insulin in patients with type 2 diabetes mellitus: a meta-analysis of randomized controlled trials

Ejemplares similares