1.
Comparative effectiveness of sodium-glucose co-transporter 2 inhibitors for controlling hyperglycaemia in patients with type 2 diabetes: protocol for a systematic review and network meta-analysis.
Chen, M, Xie, CG, Gao, H, Zheng, H, Chen, Q, Fang, JQ
BMJ open. 2016;(1):e010252
Abstract
INTRODUCTION As a new class of glucose-lowering drugs, sodium-glucose co-transporter 2 (SGLT2) inhibitors are effective for controlling hyperglycaemia, however, the relative effectiveness and safety of 6 recently available SGLT2 inhibitors have rarely been studied. Therefore, we aim to perform pairwise comparisons of the 6 SGLT2 inhibitors. METHODS AND ANALYSIS A systematic review and network meta-analysis will be conducted. Clinical studies that examine effectiveness and safety of either canagliflozin, dapagliflozin, empagliflozin, ipragliflozin, tofogliflozin or luseogliflozin will be included. These studies will be systematically retrieved in MEDLINE, EMBASE and the Cochrane Library, from inception to November 2015. Two reviewers will independently screen for eligible studies and then extract data from the studies as well as assess risk of bias. Discrepancies in screening and data extraction will be arbitrated by a third reviewer. A traditional meta-analysis will be performed to combine the effect sizes calculated from head-to-head comparisons with a random effect model. The effect sizes computed from indirect comparisons will be further combined in a network meta-analysis. Heterogeneity will be tested with the Cochrane's Q statistic, and publication bias will be assessed using a funnel plot and the Egger's test. ETHICS AND DISSEMINATION Relative effectiveness and harms of the 6 SGLT2 inhibitors will be demonstrated through this systematic review and network meta-analysis. The result of the review will be disseminated through a peer-review journal and conference presentations. Patients, clinicians and policymakers will benefit from this review in selecting a SGLT2 inhibitor for glucose control in patients with type 2 diabetes. TRIAL REGISTRATION NUMBER PROSPERO CRD42015025981.
2.
Glucose metabolism among residents in Shanghai: natural outcome of a 5-year follow-up study.
Qian, Q, Li, X, Huang, X, Fu, M, Meng, Z, Chen, M, Feng, B
Journal of endocrinological investigation. 2012;(5):453-8
Abstract
BACKGROUND Previous studies have shown that Type 2 diabetes mellitus (T2DM) is usually preceded by a condition known as pre-diabetes. However, few studies evaluate the rate of each status of impaired glucose regulation progressed to T2DM and its related metabolic disorders impacting the development. AIM: To investigate the natural outcome of glucose metabolism among Shanghai adult residents during a 5-yr period, and estimate the metabolic characteristics related with the conversion of glucose tolerance. SUBJECTS AND METHODS A cross-sectional survey with multiple- stage and random sampling was conducted among 1869 adult residents from Shanghai Pudong New District in 2002. In 2007, 1042 non-diabetic subjects were successfully followed up. All the participants completed a questionnaire and underwent anthropometric measurements and a 75-g oral glucose tolerance test. RESULTS The incidence of diabetes was higher in isolated impaired glucose tolerance (i- IGT), isolated impaired fasting glucose (i-IFG), and combined fasting and post-prandial hyperglycemia (IFG/IGT) group when compared to that in normal glucose tolerance group, as relative ratios with 95% confidence intervals of 9.2 (5.5- 15.2), 7.5 (3.6-15.7), and 13.2 (5.8-30.2), respectively. Subjects who had 2 or more metabolic disorders had a 2-3-fold higher incidence than those with less than 1 metabolic disorder (all p<0.001). CONCLUSIONS People with pre-diabetes are at increased risk of diabetes, suggesting the need for frequent screening in theloe people with several metabolic disorders.