Huang Jiayan, Qiu Huawei, Meng Kaishun
Department of Pharmacy, Guangdong Provincial Hospital of Chinese Medicine, Hainan Hospital, Haikou City, Hainan Province, China.
Department of Geriatrics, Sanya People's Hospital, West China (Sanya) Hospital, Sichuan University, Sanya City, Hainan Province, China.
Iran J Public Health. 2025 Jul;54(7):1350-1363. doi: 10.18502/ijph.v54i7.19114.
We aimed to evaluate the efficacy and safety of combined hypoglycemic agents and insulin therapy in the middle-aged and elderly patients with diabetes through a meta-analysis.
Literature was searched in PubMed, Cochrane Library, EMbase, Web of Science, WanFang, VIP, and CNKI databases for studies on the combined use of hypoglycemic agents and insulin therapy in the middle-aged and elderly patients with diabetes, with a search time limit up to February 2023.
This article includes 8 RCTs. The risk of bias assessment shows that one article had a low risk of bias, one article have an unclear risk of bias, and 6 articles have a high risk of bias. The meta-analysis results show that the combination of hypoglycemic agents and insulin has better blood glucose control (=0.0001); fasting blood glucose reduction is more significant (<0.00001); the 2-hour postprandial blood glucose reduction is more noticeable (=0.002); HbA1c reduction is more pronounced (=0.005); however, there is no difference in the incidence of adverse reactions between the two groups (=0.09).
The combination of hypoglycemic agents and insulin in the treatment of middle-aged and elderly diabetic patients can reduce the fasting blood glucose, the 2-hour postprandial blood glucose, and HbA1c, and reduce adverse reactions. However, due to the limitations in the number and quality of the included studies, the conclusion still requires further verification from more high-quality RCTs.
我们旨在通过一项荟萃分析评估联合降糖药物与胰岛素治疗对中老年糖尿病患者的疗效和安全性。
在PubMed、Cochrane图书馆、EMbase、Web of Science、万方、维普和知网数据库中检索关于联合使用降糖药物与胰岛素治疗中老年糖尿病患者的研究，检索时间截至2023年2月。
本文纳入8项随机对照试验。偏倚风险评估显示，1篇文章偏倚风险低，1篇文章偏倚风险不明确，6篇文章偏倚风险高。荟萃分析结果显示，联合使用降糖药物与胰岛素能更好地控制血糖（P = 0.0001）；空腹血糖降低更显著（P < 0.00001）；餐后2小时血糖降低更明显（P = 0.002）；糖化血红蛋白降低更显著（P = 0.005）；然而两组不良反应发生率无差异（P = 0.09）。
联合使用降糖药物与胰岛素治疗中老年糖尿病患者可降低空腹血糖、餐后2小时血糖和糖化血红蛋白，并减少不良反应。然而，由于纳入研究的数量和质量存在局限性，该结论仍需更多高质量随机对照试验进一步验证。
