Effect of Dipeptidyl Peptidase 4 Inhibitors Used in Combination with Insulin Treatment in Patients with Type 2 Diabetes: A Systematic Review and Meta-analysis

• Published in: Diabetes therapy 2020-10, Vol.11 (10), p.2371-2382
• Main Authors: Yang, Jin, Tian, Qing, Tang, Yuexin, Shah, Arvind K., Zhang, Ruya, Chen, Guojuan, Zhang, Ye, Rajpathak, Swapnil, Hong, Tianpei
• Format: Article
• Language: English
• Subjects: Cardiology; Development and progression; Diabetes; Dosage and administration; Drug therapy; Drug therapy, Combination; Endocrinology; Enzyme inhibitors; Hypoglycemia; Inhibitor drugs; Insulin; Internal Medicine; Medicine; Medicine & Public Health; Meta-analysis; Methods; Original Research; Patient outcomes; Type 2 diabetes
• ISSN: 1869-6953; 1869-6961
• DOI: 10.1007/s13300-020-00914-x

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