PMID- 31271575
OWN - NLM
STAT- MEDLINE
DCOM- 20191031
LR  - 20231003
IS  - 2359-4292 (Electronic)
IS  - 2359-3997 (Print)
IS  - 2359-3997 (Linking)
VI  - 63
IP  - 5
DP  - 2019
TI  - Efficacy and safety of sodium-glucose cotransporter-2 inhibitors in type 2 
      diabetes mellitus with inadequate glycemic control on metformin: a meta-analysis.
PG  - 478-486
LID - 10.20945/2359-3997000000146 [doi]
AB  - OBJECTIVES: To provide a meta-analysis of the clinical efficacy and safety of 
      sodium glucose co-transporter 2 inhibitors (SGLT2-i), as a combination treatment 
      with metformin in type 2 diabetes mellitus (T2DM) patients with inadequate 
      glycemic control with metformin alone. MATERIALS AND METHODS: We have searched 
      randomized controlled trials (RCTs) in the database: MEDLINE, Embase and Cochrane 
      Collaborative database. We used mean differences (MD) to assess the efficacy of 
      glycemic and other clinical parameters, and risk ratios (RR) to evaluate the 
      adverse events for safety endpoints. The heterogeneity was evaluated by I2. 
      RESULTS: Finally 9 studies were included. SGLT2-i plus metformin had higher 
      reduction level in HbA1C [MD = -0.50, 95% CI (-0.62, -0.38), p < 0.00001], FPG 
      [MD = -1.12, 95%CI (-1.38, -0.87), p < 0.00001], body weight [MD = -1.72, 95% CI 
      (-2.05, -1.39), p < 0.00001], SBP [MD = -4.44, 95% CI (-5.45, -3.43), p < 
      0.00001] and DBP [MD = -1.74, 95% CI (-2.40, -1.07), p < 0.00001] compared with 
      metformin monotherapy. However, SGLT2-i plus metformin group had higher risk of 
      genital infection [RR = 3.98, 95% CI (2.38, 6.67), p < 0.00001]. No significant 
      difference was found in the risk of hypoglycemia, urinary tract infection or 
      volume related adverse events. CONCLUSIONS: Although the risk of genital 
      infection may increase, SGLT2-i plus metformin may provide an attractive 
      treatment option to those T2DM patients who are unable to achieve glycemic 
      control with metformin alone, based on its effects on glycemic control, reducing 
      body weight and lowering blood pressure.
FAU - Jingfan, Zhang
AU  - Jingfan Z
AUID- ORCID: 0000-0001-5567-4262
AD  - Department of Endocrinology, Shengjing Hospital of China Medical University, 
      Shenyang, Liaoning Province, China.
FAU - Ling, Li
AU  - Ling L
AUID- ORCID: 0000-0002-1940-8693
AD  - Department of Endocrinology, Shengjing Hospital of China Medical University, 
      Shenyang, Liaoning Province, China.
FAU - Cong, Liu
AU  - Cong L
AUID- ORCID: 0000-0002-0150-9146
AD  - Department of Endocrinology, Shengjing Hospital of China Medical University, 
      Shenyang, Liaoning Province, China.
FAU - Ping, Li
AU  - Ping L
AUID- ORCID: 0000-0002-3465-3443
AD  - Department of Endocrinology, Shengjing Hospital of China Medical University, 
      Shenyang, Liaoning Province, China.
FAU - Yu, Chen
AU  - Yu C
AUID- ORCID: 0000-0001-9682-7894
AD  - Department of Endocrinology, Shengjing Hospital of China Medical University, 
      Shenyang, Liaoning Province, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20190627
PL  - Brazil
TA  - Arch Endocrinol Metab
JT  - Archives of endocrinology and metabolism
JID - 101652058
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
RN  - 9100L32L2N (Metformin)
SB  - IM
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Drug Therapy, Combination
MH  - Humans
MH  - Hypoglycemic Agents/*administration & dosage
MH  - Metformin/*administration & dosage
MH  - Randomized Controlled Trials as Topic
MH  - Sodium-Glucose Transporter 2 Inhibitors/*administration & dosage
PMC - PMC10522269
COIS- Disclosure: no potential conflict of interest relevant to this article was 
      reported.
EDAT- 2019/07/05 06:00
MHDA- 2019/11/02 06:00
PMCR- 2019/06/19
CRDT- 2019/07/05 06:00
PHST- 2018/10/08 00:00 [received]
PHST- 2019/04/08 00:00 [accepted]
PHST- 2019/07/05 06:00 [pubmed]
PHST- 2019/11/02 06:00 [medline]
PHST- 2019/07/05 06:00 [entrez]
PHST- 2019/06/19 00:00 [pmc-release]
AID - S2359-39972019005005102 [pii]
AID - 2359-3997000000146 [pii]
AID - 10.20945/2359-3997000000146 [doi]
PST - epublish
SO  - Arch Endocrinol Metab. 2019 Jun 27;63(5):478-486. doi: 
      10.20945/2359-3997000000146. eCollection 2019.