Effect of Verapamil on Blood Glucose in Type 1 and Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.

IF 3.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Drugs and Therapy Pub Date : 2025-03-20 DOI:10.1007/s10557-025-07683-4

Shiqi Tu, Ruiqi Zhang, Qiyue Zheng, Jiaojiao Wang, Yun Chen, Xiaosi Li, Jieyu He, Zhaokai Zhou, Qiong Lu

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引用次数: 0

Abstract

Purpose: Verapamil, an L-type calcium channel blocker treating hypertension, arrhythmia, and other cardiovascular diseases, has emerged as a potential drug for lowering blood glucose by regulating cellular calcium homeostasis and affecting expression of apoptosis-related proteins in pancreatic β-cells. However, this promising effect must be weighed against potential risks, including cardiovascular adverse effects of this drug.

Methods: We conducted a systematic review and meta-analysis and included randomized controlled trials (RCTs) assessing verapamil in individuals with type 1 or type 2 diabetes. The primary outcomes were glycated hemoglobin (HbA1c) and serum glucose concentration. The secondary outcomes were area under the curve (AUC) values for C-peptide level, body weight, changes in HbA1c and blood glucose concentration pre- and post-intervention, and adverse drug reactions.

Results: A total of eight RCTs involving 1100 patients were included in the analysis. Meta-analysis showed that verapamil effectively lowered blood glucose levels (weighted mean difference [WMD] -6.38, 95% CI -12.52, -0.25 mg/dL, P = 0.04; 6 trials), decreased HbA1c (WMD -0.45, 95% CI -0.66, -0.23%, P < 0.001; 7 trials), and increased C-peptide AUC (WMD 0.27, 95% CI 0.21, 0.32 pmol/mL, P < 0.0001; 2 trials) in patients with both type 1 and type 2 diabetes, without significant trial-related adverse events (OR 1.33, 95% CI 0.85, 2.09, P = 0.21).

Conclusion: The adjunctive use of verapamil to standard hypoglycemic therapy is a safe and effective means of improving glycemic control in diabetic patients. However, the limited scale of RCTs and heterogeneity of basic glucose-lowering regimens across studies might constrain generalizability of these findings. Future high-quality research is warranted to further elucidate the role of verapamil in diabetes management.

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维拉帕米对 1 型和 2 型糖尿病患者血糖的影响：系统回顾与元分析》。

目的：维拉帕米是一种治疗高血压、心律失常和其他心血管疾病的l型钙通道阻滞剂，已成为一种通过调节细胞钙稳态和影响胰腺β细胞凋亡相关蛋白表达来降低血糖的潜在药物。然而，这种有希望的效果必须权衡潜在的风险，包括这种药物的心血管不良反应。方法：我们进行了一项系统回顾和荟萃分析，并纳入了随机对照试验（rct），评估维拉帕米对1型或2型糖尿病患者的影响。主要结局是糖化血红蛋白（HbA1c）和血清葡萄糖浓度。次要结果为c肽水平曲线下面积（AUC）值、体重、干预前后HbA1c和血糖浓度变化、药物不良反应。结果：共纳入8项rct，共纳入1100例患者。meta分析显示维拉帕米有效降低血糖水平(加权平均差[WMD] -6.38, 95% CI -12.52, -0.25 mg/dL, P = 0.04；6项试验)，降低HbA1c （WMD -0.45, 95% CI -0.66, -0.23%， P）结论：辅助使用异拉帕米标准降糖治疗是改善糖尿病患者血糖控制的安全有效的手段。然而，随机对照试验的有限规模和研究中基本降糖方案的异质性可能限制了这些发现的普遍性。未来的高质量研究将进一步阐明维拉帕米在糖尿病治疗中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular Drugs and Therapy 医学-心血管系统

CiteScore

8.30

自引率

0.00%

发文量

110

审稿时长

4.5 months

期刊介绍： Designed to objectively cover the process of bench to bedside development of cardiovascular drug, device and cell therapy, and to bring you the information you need most in a timely and useful format, Cardiovascular Drugs and Therapy takes a fresh and energetic look at advances in this dynamic field. Homing in on the most exciting work being done on new therapeutic agents, Cardiovascular Drugs and Therapy focusses on developments in atherosclerosis, hyperlipidemia, diabetes, ischemic syndromes and arrhythmias. The Journal is an authoritative source of current and relevant information that is indispensable for basic and clinical investigators aiming for novel, breakthrough research as well as for cardiologists seeking to best serve their patients. Providing you with a single, concise reference tool acknowledged to be among the finest in the world, Cardiovascular Drugs and Therapy is listed in Web of Science and PubMed/Medline among other abstracting and indexing services. The regular articles and frequent special topical issues equip you with an up-to-date source defined by the need for accurate information on an ever-evolving field. Cardiovascular Drugs and Therapy is a careful and accurate guide through the maze of new products and therapies which furnishes you with the details on cardiovascular pharmacology that you will refer to time and time again.