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

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dc.contributor University of Helsinki, Clinicum en
dc.contributor.author Coleman, Ruth L.
dc.contributor.author Scott, Charles A. B.
dc.contributor.author Lang, Zhihui
dc.contributor.author Bethel, M. Angelyn
dc.contributor.author Tuomilehto, Jaakko
dc.contributor.author Holman, Rury R.
dc.date.accessioned 2019-11-08T11:31:02Z
dc.date.available 2019-11-08T11:31:02Z
dc.date.issued 2019-10-17
dc.identifier.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 en
dc.identifier.issn 1475-2840
dc.identifier.other PURE: 127992811
dc.identifier.other PURE UUID: 3b3e15d6-2e01-4258-83f3-e8cef2cf6b0e
dc.identifier.other WOS: 000490978500001
dc.identifier.uri http://hdl.handle.net/10138/306833
dc.description.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. en
dc.format.extent 7
dc.language.iso eng
dc.relation.ispartof Cardiovascular Diabetology
dc.rights en
dc.subject Impaired glucose tolerance en
dc.subject Type 2 diabetes en
dc.subject Cardiovascular disease en
dc.subject Alpha glucosidase inhibitor en
dc.subject Meta-analysis en
dc.subject DOUBLE-BLIND TRIAL en
dc.subject ACARBOSE en
dc.subject INTERVENTION en
dc.subject PREVENTION en
dc.subject TOLERANCE en
dc.subject PROGRESSION en
dc.subject MORTALITY en
dc.subject MELLITUS en
dc.subject RISK en
dc.subject 3121 Internal medicine en
dc.title Meta-analysis of the impact of alpha-glucosidase inhibitors on incident diabetes and cardiovascular outcomes en
dc.type Article
dc.description.version Peer reviewed
dc.identifier.doi https://doi.org/10.1186/s12933-019-0933-y
dc.type.uri info:eu-repo/semantics/other
dc.type.uri info:eu-repo/semantics/publishedVersion
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