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

Show full item record

Permalink

http://hdl.handle.net/10138/306833

Citation

Coleman , R L , Scott , C A B , Lang , Z , Bethel , M A , Tuomilehto , J & Holman , R R 2019 , ' Meta-analysis of the impact of alpha-glucosidase inhibitors on incident diabetes and cardiovascular outcomes ' , Cardiovascular Diabetology , vol. 18 , no. 1 , 135 . https://doi.org/10.1186/s12933-019-0933-y

Title: Meta-analysis of the impact of alpha-glucosidase inhibitors on incident diabetes and cardiovascular outcomes
Author: Coleman, Ruth L.; Scott, Charles A. B.; Lang, Zhihui; Bethel, M. Angelyn; Tuomilehto, Jaakko; Holman, Rury R.
Contributor: University of Helsinki, Clinicum
Date: 2019-10-17
Number of pages: 7
Belongs to series: Cardiovascular Diabetology
ISSN: 1475-2840
URI: http://hdl.handle.net/10138/306833
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 I-2 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.
Subject: Impaired glucose tolerance
Type 2 diabetes
Cardiovascular disease
Alpha glucosidase inhibitor
Meta-analysis
DOUBLE-BLIND TRIAL
ACARBOSE
INTERVENTION
PREVENTION
TOLERANCE
PROGRESSION
MORTALITY
MELLITUS
RISK
3121 Internal medicine
Rights:


Files in this item

Total number of downloads: Loading...

Files Size Format View
document_2.pdf 1.202Mb PDF View/Open

This item appears in the following Collection(s)

Show full item record