PMID- 24688145
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140624
LR  - 20211021
IS  - 0011-393X (Print)
IS  - 0011-393X (Linking)
VI  - 71
IP  - 4
DP  - 2010 Aug
TI  - Glucagon-like peptide-1 receptor agonists versus insulin glargine for type 2 
      diabetes mellitus: A systematic review and meta-analysis of randomized controlled 
      trials.
PG  - 211-38
LID - 10.1016/j.curtheres.2010.08.003 [doi]
AB  - BACKGROUND: Glucagon-like peptide-1 (GLP-1) receptor agonists are a new class of 
      hypoglycemic drugs, including exenatide, liraglutide, albiglutide, lixisenatide, 
      and taspoglutide. Insulin glargine is a standard agent used to supplement basal 
      insulin in type 2 diabetes mellitus (T2DM). OBJECTIVE: The aim of this study was 
      to review the efficacy and safety profiles of GLP-1 receptor agonists versus 
      insulin glargine in type 2 diabetic patients who have not achieved treatment 
      goals with oral hypoglycemic agents. METHODS: The Cochrane Library, MEDLINE, 
      EMBASE, Science Citation Index Expanded, and the database of ongoing trials were 
      searched from inception through April 2010. Additional data were sought from 
      relevant Web sites, the American Diabetes Association, reference lists of 
      included trials and related (systematic) reviews, and industry. Randomized 
      controlled trials (RCTs) were selected if they were >/=3 months in duration, 
      compared GLP-1 receptor agonists with insulin glargine in patients with T2DM, and 
      included >/=1 of the following outcomes: mortality, complications of T2DM, glycemie 
      control, weight, lipids, blood pressure, adverse effects, and health-related 
      quality of life. Quasirandomized controlled trials were excluded. The quality of 
      the eligible studies was assessed on the basis of the following aspects: 
      randomization procedure, allocation concealment, blinding, incomplete outcome 
      data (intent-to-treat [ITT] analysis), selective outcome reporting, and 
      publication bias. RESULTS: A total of 410 citations were retrieved; 5 multicenter 
      RCTs that met the inclusion criteria were identified. They were all open-label 
      designs with an insulin glargine arm, predefined outcomes reported, and ITT 
      analysis. One trial had an unclear randomization procedure and allocation 
      concealment. Publication bias was not able to be determined. No data wete found 
      with regard to mortality or diabetes-associated complications, and few data were 
      found on quality of life. The results of the metaanalysis suggest that insulin 
      glargine was significantly better in reducing the fasting blood glucose (mean 
      difference [MD] [95% CI], 1.31 [1.04 to 1.58]; P < 0.001), but exhibits greater 
      incidence of nocturnal hypoglycemia (risk ratio [RR] [95% CI], 0.40 [0.23 to 
      0.71]; P = 0.002) and influenza (RR [95% CI], 0.56 [0.32 to 0.98]; P = 0.04). 
      GLP-1 receptor agonists are more conducive to reducing weight (MD [95% CI], -3.96 
      [-5.14 to -2.77]; P < 0.001), postprandial blood glucose (after breakfast, P < 
      0.001; after dinner, P < 0.001), and LDL-C (MD [95% CI], -0.18 [-0.28 to -0.08]; 
      P < 0.001), but have significantly more gastrointestinal adverse effects (eg, 
      nausea/ vomiting, P < 0.001). There were no significant differences between GLP-1 
      receptor agonists and insulin glargine in reducing glycosylated hemoglobin 
      (HbA1c) levels (MD [95% CI], -0.03 [-0.13 to 0.08]) and the overall incidence of 
      hypoglycemia (RR [95% CI], 0.69 [0.42 to 1.14]). CONCLUSIONS: Compared with 
      insulin glargine, GLP-1 receptor agonists did not have a significant difference 
      in regard to reducing HbA1c levels and they were significantly associated with 
      decreased weight but increased gastrointestinal adverse events. It remains 
      unclear whether GLP-1 receptor agonists influence mortality or 
      diabetes-associated complications in patients with T2DM. More trials with longer 
      follow-up are needed to determine the exact long-term efficacy and safety 
      profiles of this new class of hypoglycemic drugs.
FAU - Li, Wei-Xin
AU  - Li WX
AD  - Department of Geriatrics, First Hospital of Lanzhou University, Lanzhou, China ; 
      Evidence-Based Medicine Center of Lanzhou University, Lanzhou, China.
FAU - Gou, Jian-Feng
AU  - Gou JF
AD  - College of Earth and Environmental Sciences of Lanzhou University, Lanzhou, 
      China.
FAU - Tian, Jin-Hui
AU  - Tian JH
AD  - Evidence-Based Medicine Center of Lanzhou University, Lanzhou, China.
FAU - Yan, Xiang
AU  - Yan X
AD  - Department of Geriatrics, First Hospital of Lanzhou University, Lanzhou, China ; 
      Evidence-Based Medicine Center of Lanzhou University, Lanzhou, China.
FAU - Yang, Lin
AU  - Yang L
AD  - Department of Geriatrics, First Hospital of Lanzhou University, Lanzhou, China.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Ther Res Clin Exp
JT  - Current therapeutic research, clinical and experimental
JID - 0372621
PMC - PMC3969618
OTO - NOTNLM
OT  - GLP-1
OT  - diabetes mellitus
OT  - glucagon-like peptide-1
OT  - insulin detemir
OT  - insulin glargine
OT  - meta-analysis
OT  - type 2 diabetes
EDAT- 2010/08/01 00:00
MHDA- 2010/08/01 00:01
PMCR- 2010/08/01
CRDT- 2014/04/02 06:00
PHST- 2010/06/09 00:00 [accepted]
PHST- 2014/04/02 06:00 [entrez]
PHST- 2010/08/01 00:00 [pubmed]
PHST- 2010/08/01 00:01 [medline]
PHST- 2010/08/01 00:00 [pmc-release]
AID - S0011-393X(10)00064-0 [pii]
AID - 10.1016/j.curtheres.2010.08.003 [doi]
PST - ppublish
SO  - Curr Ther Res Clin Exp. 2010 Aug;71(4):211-38. doi: 
      10.1016/j.curtheres.2010.08.003.