Na Wang , Teng Yang , Xiuli Feng , Guofeng Wang , Liujing
{"title":"二肽肽酶-4 抑制剂联合胰岛素对自身免疫性糖尿病患者的疗效和安全性：最新荟萃分析","authors":"Na Wang , Teng Yang , Xiuli Feng , Guofeng Wang , Liujing","doi":"10.1016/j.endmts.2024.100174","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>It is still controversial about the efficacy of Diptptidyl peptidase-4 (DPP4) inhibitors in the treatment of autoimmune diabetes, especially it is unclear whether different drugs have different efficacy for different subtypes of autoimmune diabetes.</p></div><div><h3>Aims</h3><p>To evaluated the efficacy and safety of different DPP-4 inhibitors (Sitagliptin or saxagliptin) combined with insulin in the treatment of different subtypes of autoimmune diabetes.</p></div><div><h3>Methods</h3><p>We searched PubMed, Embase, Cochrane library, Web of Science, Wanfang and CNKI databases from inception to August 2022 to identify correlational studies. Then, RevMan 5.4 and Stata 17.0 software were used to make forest plots. Weighted mean difference (WMD) or odds ratio (OR) with 95 %CI to evaluated the outcomes of Saxagliptin or Sitagliptin combined with insulin in the treatment of autoimmune diabetes.</p></div><div><h3>Results</h3><p>18 studies consisting of 811 patients were included. Our study revealed Sitagliptin or Saxagliptin both have decrease insulin dose without increase the occurrence of hypoglycemia and adverse event, regardless of subtypes of autoimmune diabetes. Saxagliptin did not statistically improve in glucose control and beta cell function in both LADA and T1DM. However, compared with T1DM, Sitagliptin decreased HbA1c and improved islet beta cell function in patients with LADA.</p></div><div><h3>Conclusions</h3><p>Sitagliptin combined with insulin therapy in patients with LADA significantly improve glucose control and beta cell function, decrease insulin dose without increasing the occurrence of hypoglycemia and adverse event. Further research in this field is required.</p></div><div><h3>Clinical relevance</h3><p>DPP-4 inhibitors combined with insulin therapy in patients with autoimmune diabetes significantly reduced blood glycemic, preserve islet beta cell function, decrease insulin dose, BMI and the incidence of hypoglycemia, and do not increase the incidence of adverse events.</p></div>","PeriodicalId":34427,"journal":{"name":"Endocrine and Metabolic Science","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666396124000189/pdfft?md5=29d3fa1908ead74aa518d5c4da166aa7&pid=1-s2.0-S2666396124000189-main.pdf","citationCount":"0","resultStr":"{\"title\":\"The efficacy and safety of Diptptidyl peptidase-4 inhibitors combined with insulin in patients with autoimmune diabetes: A updated meta-analysis\",\"authors\":\"Na Wang , Teng Yang , Xiuli Feng , Guofeng Wang , Liujing\",\"doi\":\"10.1016/j.endmts.2024.100174\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>It is still controversial about the efficacy of Diptptidyl peptidase-4 (DPP4) inhibitors in the treatment of autoimmune diabetes, especially it is unclear whether different drugs have different efficacy for different subtypes of autoimmune diabetes.</p></div><div><h3>Aims</h3><p>To evaluated the efficacy and safety of different DPP-4 inhibitors (Sitagliptin or saxagliptin) combined with insulin in the treatment of different subtypes of autoimmune diabetes.</p></div><div><h3>Methods</h3><p>We searched PubMed, Embase, Cochrane library, Web of Science, Wanfang and CNKI databases from inception to August 2022 to identify correlational studies. Then, RevMan 5.4 and Stata 17.0 software were used to make forest plots. Weighted mean difference (WMD) or odds ratio (OR) with 95 %CI to evaluated the outcomes of Saxagliptin or Sitagliptin combined with insulin in the treatment of autoimmune diabetes.</p></div><div><h3>Results</h3><p>18 studies consisting of 811 patients were included. Our study revealed Sitagliptin or Saxagliptin both have decrease insulin dose without increase the occurrence of hypoglycemia and adverse event, regardless of subtypes of autoimmune diabetes. Saxagliptin did not statistically improve in glucose control and beta cell function in both LADA and T1DM. However, compared with T1DM, Sitagliptin decreased HbA1c and improved islet beta cell function in patients with LADA.</p></div><div><h3>Conclusions</h3><p>Sitagliptin combined with insulin therapy in patients with LADA significantly improve glucose control and beta cell function, decrease insulin dose without increasing the occurrence of hypoglycemia and adverse event. Further research in this field is required.</p></div><div><h3>Clinical relevance</h3><p>DPP-4 inhibitors combined with insulin therapy in patients with autoimmune diabetes significantly reduced blood glycemic, preserve islet beta cell function, decrease insulin dose, BMI and the incidence of hypoglycemia, and do not increase the incidence of adverse events.</p></div>\",\"PeriodicalId\":34427,\"journal\":{\"name\":\"Endocrine and Metabolic Science\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-04-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2666396124000189/pdfft?md5=29d3fa1908ead74aa518d5c4da166aa7&pid=1-s2.0-S2666396124000189-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Endocrine and Metabolic Science\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666396124000189\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrine and Metabolic Science","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666396124000189","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
The efficacy and safety of Diptptidyl peptidase-4 inhibitors combined with insulin in patients with autoimmune diabetes: A updated meta-analysis
Introduction
It is still controversial about the efficacy of Diptptidyl peptidase-4 (DPP4) inhibitors in the treatment of autoimmune diabetes, especially it is unclear whether different drugs have different efficacy for different subtypes of autoimmune diabetes.
Aims
To evaluated the efficacy and safety of different DPP-4 inhibitors (Sitagliptin or saxagliptin) combined with insulin in the treatment of different subtypes of autoimmune diabetes.
Methods
We searched PubMed, Embase, Cochrane library, Web of Science, Wanfang and CNKI databases from inception to August 2022 to identify correlational studies. Then, RevMan 5.4 and Stata 17.0 software were used to make forest plots. Weighted mean difference (WMD) or odds ratio (OR) with 95 %CI to evaluated the outcomes of Saxagliptin or Sitagliptin combined with insulin in the treatment of autoimmune diabetes.
Results
18 studies consisting of 811 patients were included. Our study revealed Sitagliptin or Saxagliptin both have decrease insulin dose without increase the occurrence of hypoglycemia and adverse event, regardless of subtypes of autoimmune diabetes. Saxagliptin did not statistically improve in glucose control and beta cell function in both LADA and T1DM. However, compared with T1DM, Sitagliptin decreased HbA1c and improved islet beta cell function in patients with LADA.
Conclusions
Sitagliptin combined with insulin therapy in patients with LADA significantly improve glucose control and beta cell function, decrease insulin dose without increasing the occurrence of hypoglycemia and adverse event. Further research in this field is required.
Clinical relevance
DPP-4 inhibitors combined with insulin therapy in patients with autoimmune diabetes significantly reduced blood glycemic, preserve islet beta cell function, decrease insulin dose, BMI and the incidence of hypoglycemia, and do not increase the incidence of adverse events.
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