Mohammad Fakhrolmobasheri1, Amir Parsa Abhari1, Behrad Manshaee1, Maryam Heidarpour2, Davood Shafie3, Ehsan Mohammadbeigi4, Amir Mohammad Mozafari5,6, Sadegh Mazaheri-Tehrani4,7. 1. Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran. 2. Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. 3. Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran. d.shafie87@gmail.com. 4. Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. 5. Medical Library and Information Sciences Department, Health Information Technology Research Center, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. 6. Shahrekord University of Medical Sciences, Shahrekord, Iran. 7. Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Abstract
AIM: Recent studies have indicated that Sodium-GLucose co-Transporter 2 Inhibitors (SGLT2Is) may increase insulin sensitivity (IS); however, these results are heterogeneous and need to be systematically assessed. METHOD: We searched MEDLINE/PubMed, Embase, Web of Science, Scopus, Cochrane Library, Ovid, and ProQuest using a predefined search query. Randomized clinical trials on SGLT2Is with a passive control group or metformin controlled group were included. Risk of bias assessment was performed using the Cochrane risk of bias assessment tool. Meta-analysis was performed separately on studies with type 2 diabetes mellitus (T2DM) population and studies with non-T2DM population and also for passive- and active-controlled studies using standardized mean difference (SMD) as the measure of the effect size. Subgroup analysis was performed according to different types of SGLT2Is. Meta-regression analysis was performed according to the dose and duration of intervention. RESULTS: Twenty-two studies (6 on non-T2DM population) with a total of 1421 (243 non-T2DM) patients were included. Six studies (3 on T2DM and 3 on non-T2DM) were controlled by metformin, and others were passively controlled. SGLT2Is could significantly increase IS in T2DM patients (SMD = 0.72 [0.32-1.12]). SGLT2Is could reduce insulin resistance in non-T2DM population, but this was not significant. SGLT2Is were not inferior to metformin in reducing insulin resistance. Subgroup analysis indicated that dapagliflozin could significantly increase IS, but empagliflozin was not associated with significant improvement in IS. Meta-regression analysis indicated no effect for dose but duration of SGLT2I administration on IS. CONCLUSION: SGLT2Is, particularly dapagliflozin, could increase IS. These results need to be consolidated by further studies.
AIM: Recent studies have indicated that Sodium-GLucose co-Transporter 2 Inhibitors (SGLT2Is) may increase insulin sensitivity (IS); however, these results are heterogeneous and need to be systematically assessed. METHOD: We searched MEDLINE/PubMed, Embase, Web of Science, Scopus, Cochrane Library, Ovid, and ProQuest using a predefined search query. Randomized clinical trials on SGLT2Is with a passive control group or metformin controlled group were included. Risk of bias assessment was performed using the Cochrane risk of bias assessment tool. Meta-analysis was performed separately on studies with type 2 diabetes mellitus (T2DM) population and studies with non-T2DM population and also for passive- and active-controlled studies using standardized mean difference (SMD) as the measure of the effect size. Subgroup analysis was performed according to different types of SGLT2Is. Meta-regression analysis was performed according to the dose and duration of intervention. RESULTS: Twenty-two studies (6 on non-T2DM population) with a total of 1421 (243 non-T2DM) patients were included. Six studies (3 on T2DM and 3 on non-T2DM) were controlled by metformin, and others were passively controlled. SGLT2Is could significantly increase IS in T2DM patients (SMD = 0.72 [0.32-1.12]). SGLT2Is could reduce insulin resistance in non-T2DM population, but this was not significant. SGLT2Is were not inferior to metformin in reducing insulin resistance. Subgroup analysis indicated that dapagliflozin could significantly increase IS, but empagliflozin was not associated with significant improvement in IS. Meta-regression analysis indicated no effect for dose but duration of SGLT2I administration on IS. CONCLUSION: SGLT2Is, particularly dapagliflozin, could increase IS. These results need to be consolidated by further studies.
Authors: Giuseppe Daniele; Juan Xiong; Carolina Solis-Herrera; Aurora Merovci; Roy Eldor; Devjit Tripathy; Ralph A DeFronzo; Luke Norton; Muhammad Abdul-Ghani Journal: Diabetes Care Date: 2016-08-25 Impact factor: 19.112
Authors: Gregory A Roth; George A Mensah; Catherine O Johnson; Giovanni Addolorato; Enrico Ammirati; Larry M Baddour; Noël C Barengo; Andrea Z Beaton; Emelia J Benjamin; Catherine P Benziger; Aimé Bonny; Michael Brauer; Marianne Brodmann; Thomas J Cahill; Jonathan Carapetis; Alberico L Catapano; Sumeet S Chugh; Leslie T Cooper; Josef Coresh; Michael Criqui; Nicole DeCleene; Kim A Eagle; Sophia Emmons-Bell; Valery L Feigin; Joaquim Fernández-Solà; Gerry Fowkes; Emmanuela Gakidou; Scott M Grundy; Feng J He; George Howard; Frank Hu; Lesley Inker; Ganesan Karthikeyan; Nicholas Kassebaum; Walter Koroshetz; Carl Lavie; Donald Lloyd-Jones; Hong S Lu; Antonio Mirijello; Awoke Misganaw Temesgen; Ali Mokdad; Andrew E Moran; Paul Muntner; Jagat Narula; Bruce Neal; Mpiko Ntsekhe; Glaucia Moraes de Oliveira; Catherine Otto; Mayowa Owolabi; Michael Pratt; Sanjay Rajagopalan; Marissa Reitsma; Antonio Luiz P Ribeiro; Nancy Rigotti; Anthony Rodgers; Craig Sable; Saate Shakil; Karen Sliwa-Hahnle; Benjamin Stark; Johan Sundström; Patrick Timpel; Imad M Tleyjeh; Marco Valgimigli; Theo Vos; Paul K Whelton; Magdi Yacoub; Liesl Zuhlke; Christopher Murray; Valentin Fuster Journal: J Am Coll Cardiol Date: 2020-12-22 Impact factor: 24.094