Effect of dipeptidyl peptidase-4 inhibitors on postprandial glucagon level in patients with type 2 diabetes mellitus: A systemic review and meta-analysis

• Published in: Frontiers in endocrinology (Lausanne) 2022-10, Vol.13, p.994944-994944
• Main Authors: Chai, Shangyu, Zhang, Ruya, Zhang, Ye, Carr, Richard David, Zheng, Yiman, Rajpathak, Swapnil, Ji, Linong
• Format: Article
• Language: English
• Subjects: dipeptidyl peptidase-4 inhibitor; Endocrinology; glucagon; hyperglucagonemia; meta-analysis; randomized controlled trials
• ISSN: 1664-2392; 1664-2392
• DOI: 10.3389/fendo.2022.994944

AimsHyperglucagonemia occurs in the pathogenesis of type 2 diabetes mellitus (T2DM). In this meta-analysis, we summarized the effects of DPP4 inhibitors on glucagon levels in patients with T2DM. Materials and methodsRandomized controlled trials (RCTs) comparing the influence of DPP4 inhibitors on circulating glucagon levels with placebo or other oral antidiabetic drugs (OADs) in patients with T2DM were identified by searches of Medline (PubMed), Embase (Ovid), and CENTER (Cochrane Library). Only studies reporting changes in glucagon level presented as total area under the curve (AUCglucagon) using a meal or oral glucose tolerance test were included. Results were combined using a random-effects model that incorporated potential heterogeneity among the included studies. ResultsA total of 36 RCTs with moderate to high quality were included. Overall, the numbers of T2DM patients included for the meta-analyses comparing DPP4 inhibitors with placebo and other OADs were 4266 and 1652, respectively. Compared to placebo, DPP4 inhibitors significantly reduced circulating glucagon levels (standard mean difference [SMD]: -0.32, 95% CI: -0.40 to -0.24, P0.05). Moreover, DPP4 inhibitors significantly reduced glucagon levels compared to other OADs (SMD: -0.35, 95% CI: -0.53 to -0.16, P