Evidence map›Paper›PMID 30974510›Full record

SynthesisDiabetes/metabolism research and reviews2019

Effects of sodium-glucose cotransporter (SGLT) inhibitors in addition to insulin therapy on glucose control and safety outcomes in adults with type 1 diabetes: A meta-analysis of randomized controlled trials.

Jingli Lu, Lijuan Tang, Haiyang Meng, Junjie Zhao, Yan Liang

Abstract readMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in Diabetes/metabolism research and reviews, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 2 pooled it
5.1field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Review
  6. Article
  7. Review
  8. An Overview of the Cardiorenal Protective Mechanisms of SGLT2 Inhibitors.International journal of molecular sciences · 2022
    Review
  9. Review
  10. Article
  11. Observational
  12. Review
  13. Review
  14. Review
  15. Article
  16. Article
  17. SGLT inhibitors in type 1 diabetes: weighing efficacy and side effects.Therapeutic advances in endocrinology and metabolism · 2020
    Review
  18. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Jingli LuDepartment of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.ORCID 0000-0001-7411-1430
Lijuan TangDepartment of Medical Administration, Chengdu Women's and Children's Central Hospital, Chengdu, China.
Haiyang MengDepartment of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Junjie ZhaoDepartment of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Yan LiangDepartment of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
First Affiliated Hospital of Zhengzhou University · CNChengdu Women's and Children's Central Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Sodium-glucose cotransporter (SGLT) inhibitors added to insulin therapy have been proposed as treatment strategy for type 1 diabetes (T1D). We thus conducted a meta-analysis of randomized controlled trials (RCTs) to assess the efficacy and adverse effects of this combination in T1D. We searched the PubMed, EMBASE, and Cochrane Library databases and ClinicalTrials.gov for RCTs. Statistical analyses were performed using STATA 15. Ten eligible placebo-controlled trials involving 5961 patients were included. Compared with placebo, SGLT inhibitors were associated with a reduction in HbA1c of -0.39% (95% CI, -0.43 to -0.36), an improved mean amplitude of glucose excursion (MAGE) of -14.81 mg/dL (95% CI, -19.08 to -10.54), and a reduction in body weight of -3.47% (95% CI, -3.78 to -3.16), as well as no increased relative risk of hypoglycaemia (1.01; 95% CI, 0.99-1.02) or severe hypoglycaemia (0.91; 95% CI, 0.77-1.07). SGLT inhibitors decreased fasting plasma glucose and insulin requirement but increased the risk of genital infection (3.57; 95% CI, 2.97-4.29) and diabetic ketoacidosis (3.11; 95% CI, 2.11-4.58). However, the very low dose empagliflozin (2.5 mg) did not increase the risk of diabetic ketoacidosis (risk ratio [RR] 0.67; 95% CI, 0.11-3.95). SGLT inhibitors had no effect on overall adverse events, urinary tract infection, or bone fracture but slightly increased the risk of serious adverse events (1.35; 95% CI, 1.16-1.58), severe adverse events (1.84; 95% CI, 1.20-2.84), adverse events leading to discontinuation (1.50; 95% CI, 1.22-1.84), drug-related adverse events (1.78; 95% CI, 1.44-2.19), and diarrhoea (1.54; 95% CI, 1.15-2.05). Although adverse events exist, the available data provide evidence that the combination of SGLT inhibitors with basal insulin treatment is beneficial in patients with T1D.

Indexed as

AdultDiabetes ComplicationsDiabetes Mellitus, Type 1Drug Therapy, CombinationHumansHypoglycemic AgentsInsulin, Regular, HumanPrognosisRandomized Controlled Trials as TopicSodium-Glucose Transporter 2 InhibitorsHypoglycemic AgentsInsulin, Regular, HumanSodium-Glucose Transporter 2 Inhibitorsglucose controlsafety outcomesSGLT inhibitorstype 1 diabetes

Identifiers

PMID30974510
OpenAlexW2935716280

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.