High‐dose sodium‐glucose co‐transporter‐2 inhibitors are superior in type 2 diabetes: A meta‐analysis of randomized clinical trials

• Published in: Diabetes, obesity & metabolism obesity & metabolism, 2021-09, Vol.23 (9), p.2125-2136
• Main Authors: Shi, Fang‐Hong, Li, Hao, Shen, Long, Fu, Jing‐Jing, Ma, Jing, Gu, Zhi‐Chun, Lin, Hou‐Wen
• Format: Article
• Language: English
• Subjects: Blood pressure; Body weight; Clinical trials; clinically approved dose; Diabetes; Diabetes mellitus (non-insulin dependent); Dosage; dose dependent; efficacy; Glucose; Glucose transporter; Meta-analysis; Sensitivity analysis; sodium‐glucose co‐transporter‐2 inhibitors; type 2 diabetes
• ISSN: 1462-8902; 1463-1326
• DOI: 10.1111/dom.14452

Aim To determine the overall efficacy of high‐ versus low‐dose sodium‐glucose co‐transporter‐2 (SGLT2) inhibitors in patients with type 2 diabetes (T2D). Material and Methods A literature search using MEDLINE, EMBASE and the Cochrane Library was performed from 1 January 2006 to 23 September 2020. Random effects models were used to calculate mean differences (MDs) and pooled relative risk (RR). Prespecified subgroup analyses for each SGLT2 inhibitor, follow‐up and controls were performed. Leave‐one‐out sensitivity and meta‐regression analyses were conducted. Results A total of 51 randomized controlled trials involving 23 989 participants (weighted mean age, 58.9 years; men, 58.8%) were eligible for our meta‐analysis. For glycaemic regulation ability, a significant reduction in HbA1c (MD −0.080%, 95% confidence interval [CI] −0.100 to −0.060), fasting plasma glucose (MD −0.227 mmol/L, 95% CI −0.282 to −0.173) and postprandial plasma glucose (MD −0.834 mmol/L, 95% CI −1.268 to −0.400) levels was observed in the high‐dose SGLT2 inhibitor group. Treatment with high‐dose SGLT2 inhibitors enabled easier achievement of the target (HbA1c