Related Experiment Video
Updated: Apr 14, 2026

Author Spotlight: Network Pharmacology and Molecular Docking to Decipher the Action of Jiawei Shengjiang San Against Diabetic Kidney Disease
Published on: May 10, 2024
Antidiabetic drug and chronic respiratory disease in type 2 diabetes: a network meta-analysis and Mendelian
Ikramulhaq Patel1, Yin-He Chai1, Zi-Qi Wang1
1Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Background:
Multimorbidity management is crucial in aging populations, particularly for chronic respiratory diseases (CRDs) and diabetes. Their coexistence increases exacerbation and mortality risks. Antidiabetic drugs may differentially impact respiratory outcomes.
Objectives:
To evaluate the effects of antidiabetic drugs on CRDs in individuals with type 2 diabetes (T2D).
Design:
Systematic review with conventional and network meta-analyses (NMAs).
Data Sources And Methods:
We conducted a systematic review with conventional meta-analysis, NMA for drug comparisons, and two-sample Mendelian randomization for genetic evidence. We assessed nine antidiabetic drug classes for associations with CRD exacerbations, incidence, and all-cause mortality in individuals with T2D.
Results:
Our analysis of 33 studies (n = 939,064) found that glucagon-like peptide-1 receptor agonists (GLP1RAs) offered the strongest protection against acute exacerbations (hazard ratio vs insulin: 0.40, 95% credible interval 0.29-0.56) and had the highest first-rank probability (72.95%), followed by sodium-glucose cotransporter-2 inhibitors (SGLT2is; 46.19%). Thiazolidinediones reduced incident CRD by 21% (odds ratio (OR) 0.79, 0.69-0.91), while metformin lowered all-cause mortality risk by 16% (OR 0.84, 0.74-0.95). Mendelian randomization confirmed GLP1R expression was associated with reduced asthma risk (OR 0.9987, 0.9979-0.9996).
Conclusion:
GLP1RAs provide the strongest protection against CRD exacerbations in T2D patients, with SGLT2is as the second-most effective option. These findings highlight the potential for personalized antidiabetic therapy in multimorbidity management. Further studies should validate these findings and elucidate underlying mechanisms.
Trial Registration:
PROSPERO (ID: CRD42024542379).
Related Concept Videos
Diabetes Mellitus: Type 2 and Gestational
Oral Hypoglycemic Agents: Biguanides and Glitazones
Drugs Used in Lower Respiratory Disorders: Overview
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
Oral Hypoglycemic Agents: α-Glucosidase Inhibitors
Acarbose and miglitol are...
Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Carbohydrate Metabolism
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
