PMID- 32876863
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210118
IS  - 1869-6953 (Print)
IS  - 1869-6961 (Electronic)
IS  - 1869-6961 (Linking)
VI  - 11
IP  - 10
DP  - 2020 Oct
TI  - Effect of Dipeptidyl Peptidase 4 Inhibitors Used in Combination with Insulin 
      Treatment in Patients with Type 2 Diabetes: A Systematic Review and 
      Meta-analysis.
PG  - 2371-2382
LID - 10.1007/s13300-020-00914-x [doi]
AB  - INTRODUCTION: To evaluate the efficacy and safety of dipeptidyl peptidase 4 
      inhibitors (DPP4i) used in combination with insulin in patients with type 2 
      diabetes mellitus (T2DM). METHODS: We searched the MEDLINE, Embase, and Cochrane 
      library databases for randomized controlled trials (RCTs) published through June 
      2018. Studies with at least a 12-week treatment period were included to compare 
      the addition of DPP4i to insulin with insulin control therapy. Meanwhile, groups 
      on a stable insulin dosage (insulin-stable subgroup) or titrating insulin dosage 
      (insulin-flexible subgroup) were analyzed separately. RESULTS: Twenty-one RCTs 
      with 3697 patients randomized to a DPP4i/insulin treatment arm and 3538 to an 
      insulin control arm were included. DPP4i, when added to insulin therapy, led to a 
      significantly greater reduction in HbA1c (- 0.57%, 95% CI - 0.66, - 0.48) and 
      provided significantly greater odds of achieving the HbA1c target < 7% (OR 3.45; 
      95% CI 2.58, 4.63). These effects were achieved in the context of a decrease in 
      the daily insulin requirement, without increases in hypoglycemia risk and body 
      weight, compared with the control treatment. Subgroup analysis showed 
      control-adjusted reductions in HbA1c from baseline in the insulin-stable subgroup 
      (-  0.64%; 95% CI - 0.74, - 0.53) and the insulin-flexible subgroup (- 0.43%; 95% 
      CI - 0.56, - 0.30). Other results occurred similarly in both subgroups. 
      CONCLUSIONS: The addition of DPP4i to insulin is associated with a statistically 
      significant reduction in glycemic control as measured by HbA1c, fasting plasma 
      glucose, and 2-h postprandial glucose, without increasing the risk of 
      hypoglycemia and weight gain. These conclusions were also observed in both 
      stable-dose and flexible-dose insulin subgroups.
FAU - Yang, Jin
AU  - Yang J
AD  - Department of Endocrinology and Metabolism, Peking University Third Hospital, 
      Beijing, China.
FAU - Tian, Qing
AU  - Tian Q
AD  - Department of Endocrinology and Metabolism, Peking University Third Hospital, 
      Beijing, China.
FAU - Tang, Yuexin
AU  - Tang Y
AD  - MRL, Merck & Co., Inc., Kenilworth, NJ, USA.
FAU - Shah, Arvind K
AU  - Shah AK
AD  - MRL, Merck & Co., Inc., Kenilworth, NJ, USA.
FAU - Zhang, Ruya
AU  - Zhang R
AD  - Medical Affairs, MSD China Holding Co., Ltd., Shanghai, China.
FAU - Chen, Guojuan
AU  - Chen G
AD  - Medical Affairs, MSD China Holding Co., Ltd., Shanghai, China.
FAU - Zhang, Ye
AU  - Zhang Y
AD  - Medical Affairs, MSD China Holding Co., Ltd., Shanghai, China.
FAU - Rajpathak, Swapnil
AU  - Rajpathak S
AD  - MRL, Merck & Co., Inc., Kenilworth, NJ, USA. swapnil.rajpathak@merck.com.
FAU - Hong, Tianpei
AU  - Hong T
AD  - Department of Endocrinology and Metabolism, Peking University Third Hospital, 
      Beijing, China.
LA  - eng
PT  - Journal Article
DEP - 20200902
PL  - United States
TA  - Diabetes Ther
JT  - Diabetes therapy : research, treatment and education of diabetes and related 
      disorders
JID - 101539025
PMC - PMC7509019
OTO - NOTNLM
OT  - Dipeptidyl peptidase 4 inhibitor
OT  - Insulin
OT  - Type 2 diabetes
EDAT- 2020/09/03 06:00
MHDA- 2020/09/03 06:01
PMCR- 2020/09/02
CRDT- 2020/09/03 06:00
PHST- 2020/07/26 00:00 [received]
PHST- 2020/09/03 06:00 [pubmed]
PHST- 2020/09/03 06:01 [medline]
PHST- 2020/09/03 06:00 [entrez]
PHST- 2020/09/02 00:00 [pmc-release]
AID - 10.1007/s13300-020-00914-x [pii]
AID - 914 [pii]
AID - 10.1007/s13300-020-00914-x [doi]
PST - ppublish
SO  - Diabetes Ther. 2020 Oct;11(10):2371-2382. doi: 10.1007/s13300-020-00914-x. Epub 
      2020 Sep 2.