Sodium-Glucose Cotransporter 2 Inhibitors and New-onset Type 2 Diabetes in Adults with Prediabetes: systematic review and meta-analysis of randomized controlled trials.
Publication Title
The Journal of clinical endocrinology and metabolism
Document Type
Article
Publication Date
10-11-2022
Keywords
washington; spokane; pmrc
Abstract
CONTEXT: The preventive effect of sodium-glucose cotransporter 2 (SGLT2) inhibitors for new-onset diabetes was investigated in secondary analyses of several randomized controlled trials (RCTs). However, the results were inconsistent.
OBJECTIVE: To synthesize available evidence and evaluate whether SGLT2 inhibitors are effective in preventing new-onset diabetes.
METHODS: In this systematic review and meta-analysis of randomized controlled trials (RCTs), Medline and Embase were searched through February 11, 2022. Two independent authors screened the search results and extracted summary data from eligible randomized controlled trials (including both original and post hoc analyses) comparing sodium-glucose cotransporter 2 inhibitors and placebo for the risk of new-onset diabetes among adults with prediabetes. Meta-analysis was conducted using random-effects models to calculate risk ratios and 95% confidence intervals.
RESULTS: We included 4 RCTs with 5655 participants who had prediabetes. Based on the random-effects meta-analysis, SGLT2 inhibitors were significantly associated with a lower risk of new-onset diabetes (relative risk, 0.79; 95% CI, 0.68 to 0.93). The relative risks of new-onset diabetes in dapagliflozin and empagliflozin were 0.68 (95% CI, 0.52 to 0.89) and 0.87 (95% CI, 0.72 to 1.04), respectively (p-for-heterogeneity =0.14). The frequency of severe hypoglycemia was not elevated in the SGLT2 inhibitors group compared to the placebo group.
CONCLUSIONS: In this meta-analysis, SGLT2 inhibitors were associated with a reduced risk of new-onset type 2 diabetes among adults with prediabetes and heart failure or chronic kidney disease. These findings indicate the potential usefulness of SGLT2 inhibitors in preventing diabetes among high-risk populations with prediabetes.
Area of Special Interest
Kidney & Diabetes
Specialty/Research Institute
Endocrinology
Specialty/Research Institute
Nephrology
