Head-to-Head Comparison of the Hypoglycemic Efficacy and Safety Between Dipeptidyl Peptidase-4 Inhibitors and α-Glucosidase Inhibitors in Patients With Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials
Background: The α-glucosidase inhibitors (AGIs) are commonly prescribed in Asian patients with type 2 diabetes mellitus (T2DM), but with a high incidence of gastrointestinal side effects. This study was aimed to compare the efficacy and safety of dipeptidyl peptidase-4 (DPP4) inhibitors and AGIs in...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-07-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fphar.2019.00777/full |
| _version_ | 1818601985057751040 |
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| author | Zhaoliang Li Liang Zhao Leilei Yu Jie Yang |
| author_facet | Zhaoliang Li Liang Zhao Leilei Yu Jie Yang |
| author_sort | Zhaoliang Li |
| collection | DOAJ |
| description | Background: The α-glucosidase inhibitors (AGIs) are commonly prescribed in Asian patients with type 2 diabetes mellitus (T2DM), but with a high incidence of gastrointestinal side effects. This study was aimed to compare the efficacy and safety of dipeptidyl peptidase-4 (DPP4) inhibitors and AGIs in T2DM patients in a meta-analysis.Methods: Randomized controlled trials were identified via systematic search of PubMed, Embase, and Cochrane’s Library databases from inception to February, 2019. Meta-analyses were performed via a random or a fixed effect model according to the heterogeneity.Results: Eighteen studies with a total of 4,051 patients with T2DM were included. The DPP4 inhibitors were associated with lower reduction of glycosylated hemoglobin (HbA1c) as compared with AGIs [weighed mean difference (WMD): −0.37%, p < 0.001]. Subgroup analyses indicated that the benefit of DPP4 inhibitors as compared with AGIs on HbA1c were independent of study design, scale, baseline HbA1c, with or without concurrent medications, or follow-up durations. Moreover, compared to AGIs, DPP4 inhibitors was associated with lower reductions of fasting blood glucose (WMD: −0.53 mmol/L, P < 0.001) and postprandial glucose at 2h (WMD: −0.60 mmol/L, P = 0.04), moderately increased body weight (WMD: 0.34 kg, P = 0.02), and decreased risk of gastrointestinal adverse events [risk ratio (RR): 0.48, P < 0.001], but unaffected risk of symptomatic hypoglycemia (RR: 0.96, P = 0.90).Conclusions: The DPP4 inhibitors are superior to AGIs in T2DM patients for better glycemic control and lower risks of gastrointestinal side effects. |
| first_indexed | 2024-12-16T13:00:04Z |
| format | Article |
| id | doaj.art-171c343c603f4453a48010c1d2f7b65b |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-16T13:00:04Z |
| publishDate | 2019-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-171c343c603f4453a48010c1d2f7b65b2022-12-21T22:30:52ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122019-07-011010.3389/fphar.2019.00777470257Head-to-Head Comparison of the Hypoglycemic Efficacy and Safety Between Dipeptidyl Peptidase-4 Inhibitors and α-Glucosidase Inhibitors in Patients With Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled TrialsZhaoliang LiLiang ZhaoLeilei YuJie YangBackground: The α-glucosidase inhibitors (AGIs) are commonly prescribed in Asian patients with type 2 diabetes mellitus (T2DM), but with a high incidence of gastrointestinal side effects. This study was aimed to compare the efficacy and safety of dipeptidyl peptidase-4 (DPP4) inhibitors and AGIs in T2DM patients in a meta-analysis.Methods: Randomized controlled trials were identified via systematic search of PubMed, Embase, and Cochrane’s Library databases from inception to February, 2019. Meta-analyses were performed via a random or a fixed effect model according to the heterogeneity.Results: Eighteen studies with a total of 4,051 patients with T2DM were included. The DPP4 inhibitors were associated with lower reduction of glycosylated hemoglobin (HbA1c) as compared with AGIs [weighed mean difference (WMD): −0.37%, p < 0.001]. Subgroup analyses indicated that the benefit of DPP4 inhibitors as compared with AGIs on HbA1c were independent of study design, scale, baseline HbA1c, with or without concurrent medications, or follow-up durations. Moreover, compared to AGIs, DPP4 inhibitors was associated with lower reductions of fasting blood glucose (WMD: −0.53 mmol/L, P < 0.001) and postprandial glucose at 2h (WMD: −0.60 mmol/L, P = 0.04), moderately increased body weight (WMD: 0.34 kg, P = 0.02), and decreased risk of gastrointestinal adverse events [risk ratio (RR): 0.48, P < 0.001], but unaffected risk of symptomatic hypoglycemia (RR: 0.96, P = 0.90).Conclusions: The DPP4 inhibitors are superior to AGIs in T2DM patients for better glycemic control and lower risks of gastrointestinal side effects.https://www.frontiersin.org/article/10.3389/fphar.2019.00777/fulldipeptidyl peptidase-4 inhibitorsα-glucosidase inhibitorstype 2 diabetes mellitusmeta-analysispostprandial glucose |
| spellingShingle | Zhaoliang Li Liang Zhao Leilei Yu Jie Yang Head-to-Head Comparison of the Hypoglycemic Efficacy and Safety Between Dipeptidyl Peptidase-4 Inhibitors and α-Glucosidase Inhibitors in Patients With Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials Frontiers in Pharmacology dipeptidyl peptidase-4 inhibitors α-glucosidase inhibitors type 2 diabetes mellitus meta-analysis postprandial glucose |
| title | Head-to-Head Comparison of the Hypoglycemic Efficacy and Safety Between Dipeptidyl Peptidase-4 Inhibitors and α-Glucosidase Inhibitors in Patients With Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials |
| title_full | Head-to-Head Comparison of the Hypoglycemic Efficacy and Safety Between Dipeptidyl Peptidase-4 Inhibitors and α-Glucosidase Inhibitors in Patients With Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials |
| title_fullStr | Head-to-Head Comparison of the Hypoglycemic Efficacy and Safety Between Dipeptidyl Peptidase-4 Inhibitors and α-Glucosidase Inhibitors in Patients With Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials |
| title_full_unstemmed | Head-to-Head Comparison of the Hypoglycemic Efficacy and Safety Between Dipeptidyl Peptidase-4 Inhibitors and α-Glucosidase Inhibitors in Patients With Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials |
| title_short | Head-to-Head Comparison of the Hypoglycemic Efficacy and Safety Between Dipeptidyl Peptidase-4 Inhibitors and α-Glucosidase Inhibitors in Patients With Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials |
| title_sort | head to head comparison of the hypoglycemic efficacy and safety between dipeptidyl peptidase 4 inhibitors and α glucosidase inhibitors in patients with type 2 diabetes mellitus a meta analysis of randomized controlled trials |
| topic | dipeptidyl peptidase-4 inhibitors α-glucosidase inhibitors type 2 diabetes mellitus meta-analysis postprandial glucose |
| url | https://www.frontiersin.org/article/10.3389/fphar.2019.00777/full |
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