Insulin vs GLP-1 analogues in poorly controlled Type 2 diabetic subjects on oral therapy: A meta-analysis

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dc.contributor.authorAbdul-Ghani, Muhammed
dc.contributor.authorWilliams, Ken
dc.contributor.authorKanat, Mustafa
dc.contributor.authorAltuntaş, Yüksel
dc.contributor.authorDeFronzo, Ralph Albarado
dc.date.accessioned10.07.201910:49:13
dc.date.accessioned2019-07-10T19:58:01Z
dc.date.available10.07.201910:49:13
dc.date.available2019-07-10T19:58:01Z
dc.date.issued2013
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
dc.descriptionWOS: 000319889300005
dc.descriptionPubMed ID: 22522662
dc.description.abstractTo compare insulin and GLP-1 analogues therapy on glycemic control in poorly controlled Type 2 diabetes (T2DM) subjects failing on oral therapy. Methods: The electronic database PubMed was systematically searched for randomized controlled trial (RCT) with duration >16 weeks comparing the addition of insulin therapy vs glucagon-like peptide (GLP-1) analogues in poorly controlled T2DM subjects on oral therapy. Results: We identified 7 RCT with 2199 patients of whom 1119 were assigned to insulin therapy and 1080 received a GLP-1 analogue. Both insulin and GLP-1 analogues were effective in lowering glycated hemoglobin (HbA(1c)) with no statistically significant difference between the mean decreases in HbA(1c). However, insulin was more effective than GLP-1 analogues in lowering the fasting plasma glucose concentration, while GLP-1 agonists were more effective in lowering the postprandial glucose concentration. Insulin therapy was associated with weight gain while GLP-1 analogues consistently caused weight loss and the difference between the mean change in body weight between the two therapies was highly statistically significant. Despite a similar decrease in HbA(1c), the risk of hypoglycemia was 35% lower (p=0.001) with GLP-1 therapy compared to insulin. Compared to insulin, GLP-1 analogues caused a significant decrease in systolic blood pressure and were associated with greater rate of gastrointestinal adverse events. Conclusion/interpretation: In poorly controlled T2DM subjects on oral therapy, GLP-1 analogues and insulin are equally effective in lowering the HbA(1c). However, GLP-1 analogues have additional non-glycemic benefits and lower risk of hypoglycemia. Thus, GLP-1 analogues should be considered as a treatment option in this group of diabetic individuals.
dc.identifier.citationAbdul-Ghani, M., Williams, K., Kanat, M., Altuntaş, Y. ve DeFronzo, R. A. (2013). Insulin vs GLP-1 analogues in poorly controlled Type 2 diabetic subjects on oral therapy: A meta-analysis. Journal Of Endocrinological Investigation, 36(3), 168-173. https://dx.doi.org/10.3275/8367
dc.identifier.doi10.3275/8367
dc.identifier.endpage173
dc.identifier.issn0391-4097
dc.identifier.issue3
dc.identifier.scopusqualityQ2
dc.identifier.startpage168
dc.identifier.urihttps://dx.doi.org/10.3275/8367
dc.identifier.urihttps://hdl.handle.net/20.500.12511/3093
dc.identifier.volume36
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherEditrice Kurtis S R L
dc.relation.ispartofJournal Of Endocrinological Investigationen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/embargoedAccess
dc.subjectGLP-1 analogues
dc.subjectInsulin
dc.subjectMeta-Analysis
dc.subjectType 2 diabetes
dc.titleInsulin vs GLP-1 analogues in poorly controlled Type 2 diabetic subjects on oral therapy: A meta-analysis
dc.typeArticle

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