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Sodium glucose cotransporter2 inhibitors for type 1 diabetes mellitus: A meta-analysis of randomized controlled

Juanli Nan1, Dekai Wang1, Ruxian Zhong1

  • 1Department of General Practice, The First Affiliated Hospital of Kunming Medical University, Kunming 650031, China.

Primary Care Diabetes
|November 18, 2023
PubMed
Abstract

Insights

Sodium glucose cotransporter2 (SGLT2) inhibitors effectively reduce insulin dosage and improve glycemic control in type 1 diabetes mellitus (T1DM). This analysis confirms their safety, showing no increased risk of hypoglycemia or diabetic ketoacidosis.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Pharmacology

Background:

  • Sodium glucose cotransporter2 (SGLT2) inhibitors are under investigation for type 1 diabetes mellitus (T1DM) treatment, with ongoing debate regarding their safety and efficacy.
  • This systematic evaluation addresses the controversial use of SGLT2 inhibitors in T1DM by analyzing existing randomized controlled trials (RCTs).

Approach:

  • A comprehensive literature search was conducted across six databases up to September 2022 to identify relevant RCTs.
  • 16 RCTs involving 7192 patients were included, with data extracted and analyzed using Cochrane risk bias assessment, Revman 5.4, and Stata 17.1.

Key Points:

  • SGLT2 inhibitors significantly reduced HbA1c, fasting plasma glucose, mean amplitude of glucose excursions, body weight, and total insulin dosage.
  • Crucially, SGLT2 inhibitors did not increase the risk of hypoglycemia, urinary tract infections, or diarrhea.
  • The observed benefits were achieved without compromising patient safety in the context of T1DM management.

Conclusions:

  • This meta-analysis demonstrates that SGLT2 inhibitors can reduce insulin requirements in T1DM patients.
  • The findings support the cautious use of SGLT2 inhibitors in T1DM, as they do not appear to elevate risks of hypoglycemia or diabetic ketoacidosis within a one-month period.
Keywords:
EfficacyMeta-analysisSecuritySodium-glucose cotransporter inhibitorType 1 diabetes mellitus

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