{"title":"控制糖尿病前期患者向糖尿病转化的二甲双胍最佳剂量：一项荟萃分析。","authors":"","doi":"10.1016/j.jdiacomp.2024.108846","DOIUrl":null,"url":null,"abstract":"<div><h3>Aim</h3><p>This study aims to investigate the optimal dose of metformin for controlling the transition to diabetes in patients diagnosed with prediabetes.</p></div><div><h3>Methods</h3><p>We systematically searched randomized controlled trials (RCTs) in CNKI, Wanfang, VIP, SinoMed, Scopus, PubMed, Embase, Cochrane Library, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) from inception to February 2024. Meta-analysis was conducted using RevMan 5.4 software.</p></div><div><h3>Results</h3><p>We included 25 randomized controlled trials comprising 2437 patients. The results of the meta-analysis revealed that compared to dose groups of 500 mg/d, 850 mg/d, 1000 mg/d, 1500 mg/d, 1700 mg/d, and 2000 mg/d, a dosage of 750 mg/d of metformin significantly reduced the incidence of diabetes in patients (risk ratio [RR] = 0.21, 95 % confidence interval [CI]: 0.11, 0.41; <em>p</em> < 0.00001), lowered Postprandial Blood Glucose (PBG) (mean difference[MD] = −2.60, 95 % CI: −4.34, −0.86; <em>p</em> = 0.003), and promoted the normalization of blood glucose levels (RR = 2.13, 95 % CI: 1.68, 2.71; <em>p</em> < 0.00001). Regarding safety evaluation, no significant differences were identified among the various dose groups. In contrast, the cohort receiving a daily dosage of 750 mg demonstrated the most pronounced decrease in the incidence of adverse reactions.</p></div><div><h3>Conclusion</h3><p>Based on the efficacy and safety evaluation results, our findings suggest that a daily dosage of 750 mg of metformin may represent the optimal dose for controlling the progression from pre-diabetes to diabetes.</p></div><div><h3>Registration</h3><p>PROSPERO registration ID: CRD42024538322.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":2.9000,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The optimal dose of metformin to control conversion to diabetes in patients with prediabetes: A meta-analysis\",\"authors\":\"\",\"doi\":\"10.1016/j.jdiacomp.2024.108846\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Aim</h3><p>This study aims to investigate the optimal dose of metformin for controlling the transition to diabetes in patients diagnosed with prediabetes.</p></div><div><h3>Methods</h3><p>We systematically searched randomized controlled trials (RCTs) in CNKI, Wanfang, VIP, SinoMed, Scopus, PubMed, Embase, Cochrane Library, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) from inception to February 2024. Meta-analysis was conducted using RevMan 5.4 software.</p></div><div><h3>Results</h3><p>We included 25 randomized controlled trials comprising 2437 patients. The results of the meta-analysis revealed that compared to dose groups of 500 mg/d, 850 mg/d, 1000 mg/d, 1500 mg/d, 1700 mg/d, and 2000 mg/d, a dosage of 750 mg/d of metformin significantly reduced the incidence of diabetes in patients (risk ratio [RR] = 0.21, 95 % confidence interval [CI]: 0.11, 0.41; <em>p</em> < 0.00001), lowered Postprandial Blood Glucose (PBG) (mean difference[MD] = −2.60, 95 % CI: −4.34, −0.86; <em>p</em> = 0.003), and promoted the normalization of blood glucose levels (RR = 2.13, 95 % CI: 1.68, 2.71; <em>p</em> < 0.00001). Regarding safety evaluation, no significant differences were identified among the various dose groups. 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引用次数: 0
摘要
目的：本研究旨在探讨二甲双胍控制糖尿病前期患者向糖尿病转化的最佳剂量：我们系统地检索了从开始到2024年2月在CNKI、万方、VIP、SinoMed、Scopus、PubMed、Embase、Cochrane Library、Web of Science和Cumulative Index to Nursing and Allied Health Literature (CINAHL)中的随机对照试验（RCT）。使用 RevMan 5.4 软件进行了元分析：结果：我们纳入了 25 项随机对照试验，包括 2437 名患者。荟萃分析结果显示，与 500 毫克/天、850 毫克/天、1000 毫克/天、1500 毫克/天、1700 毫克/天和 2000 毫克/天的剂量组相比，750 毫克/天的二甲双胍剂量可显著降低患者的糖尿病发病率（风险比 [RR] = 0.21，95 % 置信区间 [CI]：0.11, 0.41; p 结论：二甲双胍可显著降低糖尿病的发病率：根据疗效和安全性评估结果，我们的研究结果表明，二甲双胍每日750毫克的剂量可能是控制糖尿病前期向糖尿病发展的最佳剂量：注册：PROSPERO 注册 ID：CRD42024538322。
The optimal dose of metformin to control conversion to diabetes in patients with prediabetes: A meta-analysis
Aim
This study aims to investigate the optimal dose of metformin for controlling the transition to diabetes in patients diagnosed with prediabetes.
Methods
We systematically searched randomized controlled trials (RCTs) in CNKI, Wanfang, VIP, SinoMed, Scopus, PubMed, Embase, Cochrane Library, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) from inception to February 2024. Meta-analysis was conducted using RevMan 5.4 software.
Results
We included 25 randomized controlled trials comprising 2437 patients. The results of the meta-analysis revealed that compared to dose groups of 500 mg/d, 850 mg/d, 1000 mg/d, 1500 mg/d, 1700 mg/d, and 2000 mg/d, a dosage of 750 mg/d of metformin significantly reduced the incidence of diabetes in patients (risk ratio [RR] = 0.21, 95 % confidence interval [CI]: 0.11, 0.41; p < 0.00001), lowered Postprandial Blood Glucose (PBG) (mean difference[MD] = −2.60, 95 % CI: −4.34, −0.86; p = 0.003), and promoted the normalization of blood glucose levels (RR = 2.13, 95 % CI: 1.68, 2.71; p < 0.00001). Regarding safety evaluation, no significant differences were identified among the various dose groups. In contrast, the cohort receiving a daily dosage of 750 mg demonstrated the most pronounced decrease in the incidence of adverse reactions.
Conclusion
Based on the efficacy and safety evaluation results, our findings suggest that a daily dosage of 750 mg of metformin may represent the optimal dose for controlling the progression from pre-diabetes to diabetes.
期刊介绍：
Journal of Diabetes and Its Complications (JDC) is a journal for health care practitioners and researchers, that publishes original research about the pathogenesis, diagnosis and management of diabetes mellitus and its complications. JDC also publishes articles on physiological and molecular aspects of glucose homeostasis.
The primary purpose of JDC is to act as a source of information usable by diabetes practitioners and researchers to increase their knowledge about mechanisms of diabetes and complications development, and promote better management of people with diabetes who are at risk for those complications.
Manuscripts submitted to JDC can report any aspect of basic, translational or clinical research as well as epidemiology. Topics can range broadly from early prediabetes to late-stage complicated diabetes. Topics relevant to basic/translational reports include pancreatic islet dysfunction and insulin resistance, altered adipose tissue function in diabetes, altered neuronal control of glucose homeostasis and mechanisms of drug action. Topics relevant to diabetic complications include diabetic retinopathy, neuropathy and nephropathy; peripheral vascular disease and coronary heart disease; gastrointestinal disorders, renal failure and impotence; and hypertension and hyperlipidemia.
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