A meta-analysis comparing clinical effects of short- or long-acting GLP-1 receptor agonists versus insulin treatment from head-to-head studies in type 2 diabetic patients

2016 ◽  
Vol 19 (2) ◽  
pp. 216-227 ◽  
Author(s):  
Mirna S. Abd El Aziz ◽  
Melanie Kahle ◽  
Juris J. Meier ◽  
Michael A. Nauck
1992 ◽  
Vol 68 (03) ◽  
pp. 253-256 ◽  
Author(s):  
Thomas Vukovich ◽  
Sylvia Proidl ◽  
Paul Knöbl ◽  
Harald Teufelsbauer ◽  
Christoph Schnack ◽  
...  

SummaryBeside hypercoagulation and hyperactivated platelets disturbances of the fibrinolytic system towards hypofibrinolysis have been reported to be associated with both glycemic and lipidemic derangement in diabetic patients. In the present prospective follow-up study the effect of 16 weeks insulin treatment and glycemic regulation on plasma levels of tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1), the main regulators of fibrinolysis, was investigated in 19 type-2 diabetic patients with secondary failure to sulphonylureas. A similar glycemic regulation was obtained in a control group of 10 type 2 diabetic patients with sufficient metabolic response to strict dietary treatment and continuation of sulphonylurea treatment. Compared to 27 healthy subjects levels of tPA and PAI-1 were not significantly increased in type 2 diabetic patients before metabolic intervention. Although a hypofibrinolytic state due to an increase of PAI-1 levels was previously reported in obese hyperinsulinemic patients, no effect of insulin treatment on both tPA- and PAI-1 levels was observed in the present study including patients with only slightly increased body mass index (median 26.0 kg/m2). By correlation analysis PAI-1 levels were significantly related to serum cholesterol (R = 0.52) and glycemic control (glucose R = 0.41) in the whole group of diabetic patients at entry and in both subgroups after 16 weeks of treatment (insulin group: cholesterol R = 0.46, HbA1c R = 0.51; sulphonylurea group: cholesterol R = 0.59, HbA1c R = 0.58). In healthy subjects tPA and PAI-1 was correlated to serum insulin (R = 0.54, R = 0.56) and triglycerides (R = 0.46, R = 0.40). In conclusion, our results indicate that insulin treatment associated with metabolic improvement has no adverse effect to fibrinolysis in type 2 diabetic patients.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Zahra Mosallanezhad ◽  
Cain Clark ◽  
Fatemeh Bahreini ◽  
Zahra Motamed ◽  
Abdolhamid Mosallanezhad ◽  
...  

Purpose The purpose of this systematic review and meta-analysis was to investigate the efficacy of propolis on glycemic indices in type 2 diabetic patients. Design/methodology/approach Web of science (ISI), Embase, Scopus and PubMed were systematically searched to find randomized controlled trials (RCTs) assessing the effects of propolis intake on glycemic controls in type 2 diabetic patients, from inception up to September 1, 2020. A random-effects model was used to pool weighted mean difference (WMD). Meta-regression was performed to detect the potential sources of inter-study heterogeneity. Findings Seven trials were included in the meta-analysis. Compared to controls, propolis intake significantly improved serum fasting blood sugar (FBS) (WMD = −13.62 mg/dl, 95% CI = [−23.04, −4.20], P = 0.005, I2 = 58.5%) and hemoglobin A1C (HbA1c) (WMD = −0.52%, 95% CI = [−0.86, −0.18], P = 0.002, I2 = 64.0%). In contrast, receiving propolis did not change serum insulin (WMD = −1.46 (uIU/ml), 95% CI = [−2.94, 0.02], P = 0.05, I2 = 75.0%) and homeostatic model assessment for insulin resistance (HOMA-IR) (WMD = −0.98 (%), 95% CI = [−2.00, 0.04], P = 0.06, I2 = 82.3%) compared to controls. Originality/value The present meta-analysis demonstrated that propolis intake significantly reduces serum FBS and HbA1c in diabetic patients but does not alter serum insulin and HOMA-IR. Further large-scale RCT’s are needed to approve these effects.


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