Incretin-based therapy in type 2 diabetes: An evidence based systematic review and meta-analysis

Journal of Diabetes and Its Complications
Greer WaldropSanjay Rajagopalan

Abstract

Incretin based therapies such as dipeptidyl peptidase-4 inhibitors (DPP-4i) and glucagon-like peptide-1 receptor agonists (GLP-1Ra) are increasingly used for the treatment of Type 2 diabetes mellitus. In clinical practice and in previously performed clinical trials, these agents are often used in combination with other oral anti-diabetic agents (OADs) and Insulin. Prior meta-analytic reviews however do not adequately address the impact of background therapy and active comparator arms. Accordingly, we aimed to further investigate the efficacy of incretin based therapies by updating existing reviews by including clinical trial evidence after 2008; estimating the pooled effect of incretin therapies on glycemic efficacy and weight-loss, stratified by comparator therapy (placebo, mono-therapy, etc.), estimating the impact of background OADs and within class (GLP-1Ra or DPP-4i) comparative efficacy, on glycemia control. 82 randomized controlled trials after 2008 with glycemic control and weight loss as primary end-points were included. Both DPP-4i and GLP-1Ra reduced HbA1c, but only GLP-1Ra caused weight loss when compared to either active comparator drugs or placebo. GLP-1Ra were more effective than DPP-4i in glycemia lowering. Long...Continue Reading

Citations

Dec 7, 2018·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Irene RomeraJesús Reviriego
Dec 28, 2019·Journal of the American College of Nutrition·Shuting LinYuan Zang
Dec 22, 2019·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·David M WilliamsMarc Evans
Dec 19, 2018·Journal of Community Hospital Internal Medicine Perspectives·Mahmoud BarbarawiGhassan Bachuwa
Dec 20, 2019·Clinical Medicine Insights. Endocrinology and Diabetes·Jens F Rehfeld
Nov 7, 2019·Critical Reviews in Food Science and Nutrition·Abdul Majid, Poornima Priyadarshini C G
Sep 12, 2021·Journal of General Internal Medicine·Jason T AlexanderNeda Laiteerapong

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