Dana El Masri1, Samiran Ghosh2, Linda A Jaber3. 1. Eugene Applebaum College of Pharmacy and Health Sciences, Department of Pharmacy Practice, Wayne State University, 259 Mack Avenue, Suite 2134, Detroit, MI 48201, USA. Electronic address: ea0782@wayne.edu. 2. Wayne State University School of Medicine, Department of Family Medicine and Public Health Sciences, Wayne State University, 6135 Woodward Ave, Rm 1128, Detroit, MI 48202, USA. Electronic address: sghos@med.wayne.edu. 3. Eugene Applebaum College of Pharmacy and Health Sciences, Department of Pharmacy Practice, Wayne State University, 259 Mack Avenue, Suite 2134, Detroit, MI 48201, USA. Electronic address: ljaber@wayne.edu.
Abstract
AIMS: Sodium-glucose cotransporter 2 (SGLT2) inhibitors are currently FDA approved for the management of type 2 diabetes. Our objective was to review the available evidence of the effects of SGLT2 inhibitors on HbA1c, body weight, and total daily insulin dose, as well as their safety profile in patients with type 1 diabetes. METHODS: Four randomized controlled trials (RCTs) were identified by conducting a systematic search of PubMed, Embase, Web of Science, Scopus and Cochrane library databases through August 2017. Data on study design, sample size, mean ± standard deviation of HbA1c, body weight, and total daily insulin dose, as well as reported adverse events were extracted. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated using a random-effects model. RESULTS: Relative to placebo, therapy with SGLT2 inhibitors led to significant reductions in HbA1c (WMD 0.39; 95% CI 0.27, 0.51), body weight (WMD 2.76; 95% CI 1.11, 4.40), and total daily insulin dose (WMD 5.03; 95% CI 1.83, 8.23). In addition, there was no significant difference in the rate of adverse events. CONCLUSIONS: The current study lends supports for the development of SGLT2 inhibitors in combination with insulin as a treatment option for patients with type 1 diabetes.
AIMS: Sodium-glucose cotransporter 2 (SGLT2) inhibitors are currently FDA approved for the management of type 2 diabetes. Our objective was to review the available evidence of the effects of SGLT2 inhibitors on HbA1c, body weight, and total daily insulin dose, as well as their safety profile in patients with type 1 diabetes. METHODS: Four randomized controlled trials (RCTs) were identified by conducting a systematic search of PubMed, Embase, Web of Science, Scopus and Cochrane library databases through August 2017. Data on study design, sample size, mean ± standard deviation of HbA1c, body weight, and total daily insulin dose, as well as reported adverse events were extracted. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated using a random-effects model. RESULTS: Relative to placebo, therapy with SGLT2 inhibitors led to significant reductions in HbA1c (WMD 0.39; 95% CI 0.27, 0.51), body weight (WMD 2.76; 95% CI 1.11, 4.40), and total daily insulin dose (WMD 5.03; 95% CI 1.83, 8.23). In addition, there was no significant difference in the rate of adverse events. CONCLUSIONS: The current study lends supports for the development of SGLT2 inhibitors in combination with insulin as a treatment option for patients with type 1 diabetes.
Authors: Bruce A Perkins; Julio Rosenstock; Jay S Skyler; Lori M Laffel; David Z Cherney; Chantal Mathieu; Christianne Pang; Richard Wood; Ona Kinduryte; Jyothis T George; Jan Marquard; Nima Soleymanlou Journal: Diabetes Care Date: 2019-06-08 Impact factor: 19.112