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High‐dose sodium‐glucose co‐transporter‐2 inhibitors are superior in type 2 diabetes: A meta‐analysis of randomized clinical trials
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. Ra...
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| Published in: | Diabetes, obesity & metabolism obesity & metabolism, 2021-09, Vol.23 (9), p.2125-2136 |
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| container_end_page | 2136 |
| container_issue | 9 |
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| container_title | Diabetes, obesity & metabolism |
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| creator | Shi, Fang‐Hong Li, Hao Shen, Long Fu, Jing‐Jing Ma, Jing Gu, Zhi‐Chun Lin, Hou‐Wen |
| description | 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 |
| doi_str_mv | 10.1111/dom.14452 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2534615033</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2559349226</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3962-c1d1e45468548e3f14cc3364650fc2bc3f28dc8a4cce5bf82c74cad6764e9d243</originalsourceid><addsrcrecordid>eNp1kU1OwzAQhSMEEqWw4AaW2MCibfwTN2FX8Vekom5gHbn2pHWVxMFOhMqKCyBxRk7CtGWFhDfjN_reaJ4mis5pPKT4RsZVQypEwg6iHhWSDyhn8nD3Z4M0i9lxdBLCOo5jwdNxL_qc2uXq--PLuAAkOGO7CtWy7PS2oR2K1qs6NM634FExYuuVXdjW-UCUR1PXgLfOY5-0mwYII8aqBbQQrsmEVNAqtKlalZtgA3EFwXm4pn0HQ3Rpa6tVSVpvVRlOo6MCC5z91n70cn_3fDMdzOYPjzeT2UDzDHNoaiiIRMg0ESnwggqtOZdCJnGh2ULzgqVGpwrbkCyKlOmx0MrIsRSQGSZ4P7rcz228e-0gtHllg4ayVDW4LuQs4ULSJOYc0Ys_6Np1HtNsqSTjImNMInW1p7R3IXgo8sbbSvlNTuN8e5gcE-e7wyA72rNvtoTN_2B-O3_aO34A13WWBw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2559349226</pqid></control><display><type>article</type><title>High‐dose sodium‐glucose co‐transporter‐2 inhibitors are superior in type 2 diabetes: A meta‐analysis of randomized clinical trials</title><source>Wiley-Blackwell Read & Publish Collection</source><creator>Shi, Fang‐Hong ; Li, Hao ; Shen, Long ; Fu, Jing‐Jing ; Ma, Jing ; Gu, Zhi‐Chun ; Lin, Hou‐Wen</creator><creatorcontrib>Shi, Fang‐Hong ; Li, Hao ; Shen, Long ; Fu, Jing‐Jing ; Ma, Jing ; Gu, Zhi‐Chun ; Lin, Hou‐Wen</creatorcontrib><description>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 <7%) than low‐dose SGLT2 inhibitors (RR 1.148, 95% CI 1.104 to 1.193). High‐dose SGLT2 inhibitor‐based treatment resulted in more efficient regulation of body weight and blood pressure (body weight: MD −0.346 kg, 95% CI −0.437 to −0.254; systolic blood pressure: MD −0.583 mmHg, 95% CI −0.903 to −0.263; diastolic blood pressure: MD −0.352 mmHg, 95% CI −0.563 to −0.142). The results were similar in sensitivity analyses.
Conclusions
The overall efficacy of SGLT2 inhibitors, mainly canagliflozin, dapagliflozin and empagliflozin, was found to be dose dependent.</description><identifier>ISSN: 1462-8902</identifier><identifier>EISSN: 1463-1326</identifier><identifier>DOI: 10.1111/dom.14452</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>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</subject><ispartof>Diabetes, obesity & metabolism, 2021-09, Vol.23 (9), p.2125-2136</ispartof><rights>2021 John Wiley & Sons Ltd.</rights><rights>2021 John Wiley & Sons Ltd</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3962-c1d1e45468548e3f14cc3364650fc2bc3f28dc8a4cce5bf82c74cad6764e9d243</citedby><cites>FETCH-LOGICAL-c3962-c1d1e45468548e3f14cc3364650fc2bc3f28dc8a4cce5bf82c74cad6764e9d243</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Shi, Fang‐Hong</creatorcontrib><creatorcontrib>Li, Hao</creatorcontrib><creatorcontrib>Shen, Long</creatorcontrib><creatorcontrib>Fu, Jing‐Jing</creatorcontrib><creatorcontrib>Ma, Jing</creatorcontrib><creatorcontrib>Gu, Zhi‐Chun</creatorcontrib><creatorcontrib>Lin, Hou‐Wen</creatorcontrib><title>High‐dose sodium‐glucose co‐transporter‐2 inhibitors are superior in type 2 diabetes: A meta‐analysis of randomized clinical trials</title><title>Diabetes, obesity & metabolism</title><description>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 <7%) than low‐dose SGLT2 inhibitors (RR 1.148, 95% CI 1.104 to 1.193). High‐dose SGLT2 inhibitor‐based treatment resulted in more efficient regulation of body weight and blood pressure (body weight: MD −0.346 kg, 95% CI −0.437 to −0.254; systolic blood pressure: MD −0.583 mmHg, 95% CI −0.903 to −0.263; diastolic blood pressure: MD −0.352 mmHg, 95% CI −0.563 to −0.142). The results were similar in sensitivity analyses.
Conclusions
The overall efficacy of SGLT2 inhibitors, mainly canagliflozin, dapagliflozin and empagliflozin, was found to be dose dependent.</description><subject>Blood pressure</subject><subject>Body weight</subject><subject>Clinical trials</subject><subject>clinically approved dose</subject><subject>Diabetes</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Dosage</subject><subject>dose dependent</subject><subject>efficacy</subject><subject>Glucose</subject><subject>Glucose transporter</subject><subject>Meta-analysis</subject><subject>Sensitivity analysis</subject><subject>sodium‐glucose co‐transporter‐2 inhibitors</subject><subject>type 2 diabetes</subject><issn>1462-8902</issn><issn>1463-1326</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kU1OwzAQhSMEEqWw4AaW2MCibfwTN2FX8Vekom5gHbn2pHWVxMFOhMqKCyBxRk7CtGWFhDfjN_reaJ4mis5pPKT4RsZVQypEwg6iHhWSDyhn8nD3Z4M0i9lxdBLCOo5jwdNxL_qc2uXq--PLuAAkOGO7CtWy7PS2oR2K1qs6NM634FExYuuVXdjW-UCUR1PXgLfOY5-0mwYII8aqBbQQrsmEVNAqtKlalZtgA3EFwXm4pn0HQ3Rpa6tVSVpvVRlOo6MCC5z91n70cn_3fDMdzOYPjzeT2UDzDHNoaiiIRMg0ESnwggqtOZdCJnGh2ULzgqVGpwrbkCyKlOmx0MrIsRSQGSZ4P7rcz228e-0gtHllg4ayVDW4LuQs4ULSJOYc0Ys_6Np1HtNsqSTjImNMInW1p7R3IXgo8sbbSvlNTuN8e5gcE-e7wyA72rNvtoTN_2B-O3_aO34A13WWBw</recordid><startdate>202109</startdate><enddate>202109</enddate><creator>Shi, Fang‐Hong</creator><creator>Li, Hao</creator><creator>Shen, Long</creator><creator>Fu, Jing‐Jing</creator><creator>Ma, Jing</creator><creator>Gu, Zhi‐Chun</creator><creator>Lin, Hou‐Wen</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>202109</creationdate><title>High‐dose sodium‐glucose co‐transporter‐2 inhibitors are superior in type 2 diabetes: A meta‐analysis of randomized clinical trials</title><author>Shi, Fang‐Hong ; Li, Hao ; Shen, Long ; Fu, Jing‐Jing ; Ma, Jing ; Gu, Zhi‐Chun ; Lin, Hou‐Wen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3962-c1d1e45468548e3f14cc3364650fc2bc3f28dc8a4cce5bf82c74cad6764e9d243</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Blood pressure</topic><topic>Body weight</topic><topic>Clinical trials</topic><topic>clinically approved dose</topic><topic>Diabetes</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Dosage</topic><topic>dose dependent</topic><topic>efficacy</topic><topic>Glucose</topic><topic>Glucose transporter</topic><topic>Meta-analysis</topic><topic>Sensitivity analysis</topic><topic>sodium‐glucose co‐transporter‐2 inhibitors</topic><topic>type 2 diabetes</topic><toplevel>online_resources</toplevel><creatorcontrib>Shi, Fang‐Hong</creatorcontrib><creatorcontrib>Li, Hao</creatorcontrib><creatorcontrib>Shen, Long</creatorcontrib><creatorcontrib>Fu, Jing‐Jing</creatorcontrib><creatorcontrib>Ma, Jing</creatorcontrib><creatorcontrib>Gu, Zhi‐Chun</creatorcontrib><creatorcontrib>Lin, Hou‐Wen</creatorcontrib><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes, obesity & metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shi, Fang‐Hong</au><au>Li, Hao</au><au>Shen, Long</au><au>Fu, Jing‐Jing</au><au>Ma, Jing</au><au>Gu, Zhi‐Chun</au><au>Lin, Hou‐Wen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High‐dose sodium‐glucose co‐transporter‐2 inhibitors are superior in type 2 diabetes: A meta‐analysis of randomized clinical trials</atitle><jtitle>Diabetes, obesity & metabolism</jtitle><date>2021-09</date><risdate>2021</risdate><volume>23</volume><issue>9</issue><spage>2125</spage><epage>2136</epage><pages>2125-2136</pages><issn>1462-8902</issn><eissn>1463-1326</eissn><abstract>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 <7%) than low‐dose SGLT2 inhibitors (RR 1.148, 95% CI 1.104 to 1.193). High‐dose SGLT2 inhibitor‐based treatment resulted in more efficient regulation of body weight and blood pressure (body weight: MD −0.346 kg, 95% CI −0.437 to −0.254; systolic blood pressure: MD −0.583 mmHg, 95% CI −0.903 to −0.263; diastolic blood pressure: MD −0.352 mmHg, 95% CI −0.563 to −0.142). The results were similar in sensitivity analyses.
Conclusions
The overall efficacy of SGLT2 inhibitors, mainly canagliflozin, dapagliflozin and empagliflozin, was found to be dose dependent.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><doi>10.1111/dom.14452</doi><tpages>12</tpages></addata></record> |
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| identifier | ISSN: 1462-8902 |
| ispartof | Diabetes, obesity & metabolism, 2021-09, Vol.23 (9), p.2125-2136 |
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| source | Wiley-Blackwell Read & Publish Collection |
| 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 |
| title | High‐dose sodium‐glucose co‐transporter‐2 inhibitors are superior in type 2 diabetes: A meta‐analysis of randomized clinical trials |
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