Molugulu Nagashekhara, Yee Lai Shu, Ye Yew Tze, Khee Tan Chew, Nie Lee Zhen, Yee Neoh Jia, Yee Tian Kar, Liang Tan Chee, Kesharwani Prashant
Department of Pharmaceutical Technology, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia.
Pharmaceutics Division, CSIR-Central Drug Research Institute, Lucknow, UP 226031, India.
Diabetes Res Clin Pract. 2017 Oct;132:157-168. doi: 10.1016/j.diabres.2017.07.025. Epub 2017 Jul 25.
Type 2 Diabetes Mellitus (T2DM) is a chronic disorder and its treatment with only metformin often does not provide optimum glycemic control. Addition of sodium glucose cotransporter 2 inhibitor (SGLT2) will improve the glycemic control in patients on metformin alone. In this study, an attempt is made to investigate the combined therapy of SGLT-2 with metformin in managing T2DM in terms of lowering HbA1c and body weight and monotherapy using metformin alone in HbA1c and body weight reduction.
To compare the clinical effectiveness of combined therapy using SGLT2 inhibitor and metformin with monotherapy using metformin alone in HbA1c and body weight reduction.
A systematic review of the randomized controlled trials has been carried out and Cochrane risk of bias tool was used for the quality assessment. Patient, Intervention, Comparison and Outcomes (PICO) technique is used to select the relevant articles to meet the objective.
The studies used in this article are multicenter, double-blinded randomized controlled trials on SGLT2 inhibitors with methformin, there were a total of 3897 participants, with a range of 182 to 1186 individual study size were included. Studies showed that combined therapy were more effective in HbA1c and body weight reduction as compared to monotherapy.
The combined therapy of SGLT2 inhibitor along with metformin is more effective in HbA1c reduction and weight reduction as compared to monotherapy using metformin alone. Among the three SGLT2 inhibitors such as dapagliflozin canagliflozin and empagliflozin do not differ much in the efficiency of weight reduction. However, Empagliflozin 25mg is effective in HbA1c reduction.
2型糖尿病（T2DM）是一种慢性疾病，仅用二甲双胍治疗往往无法实现最佳血糖控制。添加钠-葡萄糖协同转运蛋白2抑制剂（SGLT2）可改善仅使用二甲双胍治疗的患者的血糖控制。在本研究中，尝试探讨SGLT-2与二甲双胍联合治疗在控制T2DM方面降低糖化血红蛋白（HbA1c）和体重的效果，以及单独使用二甲双胍单一疗法在降低HbA1c和体重方面的效果。
比较SGLT2抑制剂与二甲双胍联合治疗和单独使用二甲双胍单一疗法在降低HbA1c和体重方面的临床疗效。
对随机对照试验进行了系统评价，并使用Cochrane偏倚风险工具进行质量评估。采用患者、干预措施、对照和结局（PICO）技术选择符合目标的相关文章。
本文使用的研究是关于SGLT2抑制剂与二甲双胍的多中心、双盲随机对照试验，共有3897名参与者，纳入的单个研究规模在182至1186之间。研究表明，与单一疗法相比，联合治疗在降低HbA1c和体重方面更有效。
与单独使用二甲双胍单一疗法相比，SGLT2抑制剂与二甲双胍联合治疗在降低HbA1c和减轻体重方面更有效。在达格列净、卡格列净和恩格列净这三种SGLT2抑制剂中，它们在减轻体重的效率方面差异不大。然而，25mg的恩格列净在降低HbA1c方面有效。
