Lee Heeyoung, Park Se-Eun, Kim Eun-Young
Department of Clinical Medicinal Sciences, Konyang University, Nonsan 32992, Korea.
Department of Internal Medicine, Division of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03063, Korea.
J Clin Med. 2021 Sep 9;10(18):4078. doi: 10.3390/jcm10184078.
To investigate the effect of sodium-glucose cotransporter 2 (SGLT-2) inhibitors and glucagon-like peptide 1 (GLP-1) agonists on glycemic variability (GV), the mean amplitude of glucose excursion (MAGE), mean blood glucose (MBG) levels, and percentage of time maintaining euglycemia were evaluated. Randomized controlled trials evaluating the efficacy of SGLT-2 inhibitors and GLP-1 agonists for treating people with diabetes were selected through searches of PubMed, EMBASE, and other databases. Sixteen studies were finally analyzed. There were no differences in the reductions in MAGE after treatment with SGLT-2 inhibitors or GLP-1 agonists (standardized mean difference (SMD) = -0.59, 95% CI = -0.82 to -0.36 vs. SMD = -0.43, 95% CI = -0.51 to -0.35, respectively), and treatment with SGLT-2 inhibitors was associated with an increased reduction in MBG levels (SMD = -0.56, 95% CI = -0.65 to -0.48, < 0.00001). Monotherapy and add-on therapy with medications were correlated with MAGE and MBG level reductions. In conclusion, SGLT-2 inhibitors and GLP-1 agonists were associated with a reduction in GV and could be alternatives for treating people with diabetes.
为研究钠-葡萄糖协同转运蛋白2（SGLT-2）抑制剂和胰高血糖素样肽1（GLP-1）激动剂对血糖变异性（GV）、血糖波动平均幅度（MAGE）、平均血糖（MBG）水平以及维持血糖正常时间百分比的影响，对相关指标进行了评估。通过检索PubMed、EMBASE及其他数据库，选取了评估SGLT-2抑制剂和GLP-1激动剂治疗糖尿病患者疗效的随机对照试验。最终分析了16项研究。SGLT-2抑制剂或GLP-1激动剂治疗后MAGE降低幅度无差异（标准化均数差（SMD）分别为=-0.59，95%CI=-0.82至-0.36与SMD=-0.43，95%CI=-0.51至-0.35），且SGLT-2抑制剂治疗与MBG水平更大幅度降低相关（SMD=-0.56，95%CI=-0.65至-0.48，<0.00001）。药物单药治疗和联合治疗与MAGE和MBG水平降低相关。总之，SGLT-2抑制剂和GLP-1激动剂与GV降低相关，可作为治疗糖尿病患者的替代药物。
