Meta-analysis of the impact of alpha-glucosidase inhibitors on incident diabetes and cardiovascular outcomes

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dc.contributor.author Coleman, Ruth L
dc.contributor.author Scott, Charles A B
dc.contributor.author Lang, Zhihui
dc.contributor.author Bethel, M. A
dc.contributor.author Tuomilehto, Jaakko
dc.contributor.author Holman, Rury R
dc.date.accessioned 2019-10-20T13:20:28Z
dc.date.available 2019-10-20T13:20:28Z
dc.date.issued 2019-10-17
dc.identifier.citation Cardiovascular Diabetology. 2019 Oct 17;18(1):135
dc.identifier.uri http://hdl.handle.net/10138/306207
dc.description.abstract Abstract Background Alpha-glucosidase inhibitors (AGIs) have been shown to reduce incident type 2 diabetes but their impact on cardiovascular (CV) disease remains controversial. We sought to identify the overall impact of AGIs with respect to incident type 2 diabetes in individuals with impaired glucose tolerance (IGT), and CV outcomes in those with IGT or type 2 diabetes. Methods We used PubMed and SCOPUS to identify randomized controlled trials reporting the incidence of type 2 diabetes and/or CV outcomes that had compared AGIs with placebo in populations with IGT or type 2 diabetes, with or without established CV disease. Eligible studies were required to have ≥ 500 participants and/or ≥ 100 endpoints of interest. Meta-analyses of available trial data were performed using random effects models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident type 2 diabetes and CV outcomes. Results Of ten trials identified, three met our inclusion criteria for incident type 2 diabetes and four were eligible for CV outcomes. The overall HR (95% CI) comparing AGI with placebo for incident type 2 diabetes was 0.77 (0.67–0.88), p < 0.0001, and for CV outcomes was 0.98 (0.89–1.10), p = 0.85. There was little to no heterogeneity between studies, with I2 values of 0.03% (p = 0.43) and 0% (p = 0.79) for the two outcomes respectively. Conclusions Allocation of people with IGT to an AGI significantly reduced their risk of incident type 2 diabetes by 23%, whereas in those with IGT or type 2 diabetes the impact on CV outcomes was neutral.
dc.publisher BioMed Central
dc.subject Impaired glucose tolerance
dc.subject Type 2 diabetes
dc.subject Cardiovascular disease
dc.subject Alpha glucosidase inhibitor
dc.subject Meta-analysis
dc.title Meta-analysis of the impact of alpha-glucosidase inhibitors on incident diabetes and cardiovascular outcomes
dc.date.updated 2019-10-20T13:20:28Z
dc.language.rfc3066 en
dc.rights.holder The Author(s)
dc.type.uri http://purl.org/eprint/entityType/ScholarlyWork
dc.type.uri http://purl.org/eprint/entityType/Expression
dc.type.uri http://purl.org/eprint/type/JournalArticle

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