Renal, cardiovascular, and safety outcomes of adding sodium-glucose cotransporter-2 inhibitors to insulin therapy in patients with type-2 diabetes: a meta-analysis.

Publisher: Springer Country of Publication: Netherlands NLM ID: 0262521 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2584 (Electronic) Linking ISSN: 03011623 NLM ISO Abbreviation: Int Urol Nephrol Subsets: MEDLINE

Publication: Amsterdam : Springer
Original Publication: Budapest, Akademiai Kiadó

Sodium-Glucose Transporter 2 Inhibitors*/adverse effects ; Diabetes Mellitus, Type 2*/drug therapy; Humans ; Insulin/adverse effects ; Hypoglycemic Agents/adverse effects ; Uric Acid ; Body Weight ; Glucose ; Sodium

Aims: To investigate the renal, cardiovascular, and safety outcomes when sodium-glucose cotransporter-2 inhibitors (SGLT2is) were added to insulin therapy in patients with type-2 diabetes mellitus (T2DM).
Materials and Methods: We searched Embase, PubMed, and Cochrane libraries for reports published up to Feb 2023. Randomized controlled trials (RCTs) comparing SGLT2is and insulin combination therapy (SGLT2is + INS group) with insulin therapy alone (INS group) in T2DM were included.
Results: Fourteen RCTs involving six thousand one hundred twenty subjects with durations of 12-104 weeks were included. Compared with the insulin group, the SGLT2is + INS group showed decreased glycosylated hemoglobin values and insulin dosages (P < 0.00001). Meanwhile, the SGLT2is + INS group had a reduced urinary albumin/creatinine ratio (UACR) by 25.42 mg/g and uric acid concentration (P = 0.030; P = 0.001, respectively) but the estimated glomerular filtration rate (eGFR) and renal-related adverse events were unaffected (P = 0.070; P = 0.880, respectively). Blood pressure and body weight were lower in the SGLT2is + INS group (P < 0.01). However, the risk of genital infection was bigger when SGLT2is were added to insulin therapy (P < 0.00001), but the risks of severe hypoglycemia or urinary tract infection were equal between the two groups (P > 0.05).
Conclusion: Adding SGLT2is to insulin therapy in T2DM patients showed better glucose control and decreased albuminuria, uric acid, blood pressure, and body weight without a reduction in the eGFR.
(© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

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WSN-336 Six Talent Peaks Project in Jiangsu Province; LGY2020067 Graduate Research and Innovation Projects of Jiangsu Province; TZKY20220110 Scientific Research Project, Taizhou School of Clinical Medicine, Nanjing Medical University

Keywords: Meta-analysis; Renal outcomes; Sodium–glucose cotransporter-2 inhibitors; Type-2 diabetes mellitus

0 (Insulin)
0 (Hypoglycemic Agents)
268B43MJ25 (Uric Acid)
0 (Sodium-Glucose Transporter 2 Inhibitors)
IY9XDZ35W2 (Glucose)
9NEZ333N27 (Sodium)

Date Created: 20230729 Date Completed: 20240126 Latest Revision: 20240126

20240126

10.1007/s11255-023-03719-6

37515749