Safety and efficacy of sodium-glucose cotransporter 2 (SGLT2) inhibitors in type 1 diabetes: A systematic review and meta-analysis

Diabetes Res Clin Pract. 2018 Mar;137:83-92. doi: 10.1016/j.diabres.2018.01.004. Epub 2018 Jan 6.

Abstract

Aims: Sodium-glucose cotransporter 2 (SGLT2) inhibitors are currently FDA approved for the management of type 2 diabetes. Our objective was to review the available evidence of the effects of SGLT2 inhibitors on HbA1c, body weight, and total daily insulin dose, as well as their safety profile in patients with type 1 diabetes.

Methods: Four randomized controlled trials (RCTs) were identified by conducting a systematic search of PubMed, Embase, Web of Science, Scopus and Cochrane library databases through August 2017. Data on study design, sample size, mean ± standard deviation of HbA1c, body weight, and total daily insulin dose, as well as reported adverse events were extracted. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated using a random-effects model.

Results: Relative to placebo, therapy with SGLT2 inhibitors led to significant reductions in HbA1c (WMD 0.39; 95% CI 0.27, 0.51), body weight (WMD 2.76; 95% CI 1.11, 4.40), and total daily insulin dose (WMD 5.03; 95% CI 1.83, 8.23). In addition, there was no significant difference in the rate of adverse events.

Conclusions: The current study lends supports for the development of SGLT2 inhibitors in combination with insulin as a treatment option for patients with type 1 diabetes.

Keywords: Meta-analysis; Sodium-glucose cotransporter 2 inhibitors; Systematic review; Type 1 diabetes.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Diabetes Mellitus, Type 1 / drug therapy*
  • Humans
  • Hypoglycemic Agents / pharmacology
  • Hypoglycemic Agents / therapeutic use*
  • Sodium-Glucose Transporter 2
  • Sodium-Glucose Transporter 2 Inhibitors*

Substances

  • Hypoglycemic Agents
  • SLC5A2 protein, human
  • Sodium-Glucose Transporter 2
  • Sodium-Glucose Transporter 2 Inhibitors