DPP-4 Inhibitors as Treatments for Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis

Objective. Several clinical studies have reported the application of dipeptidyl peptidase-4 (DPP-4) inhibitors as treatments for type 1 diabetes mellitus (T1DM). This study aims to review the outcomes of these existing studies and to discuss the therapeutic effects of DPP-4 inhibitors on T1DM. Methods. We thoroughly searched the Medline, Embase, PubMed, and Cochrane Library databases and ClinicalTrials.gov for studies concerning the use of DPP-4 inhibitors in patients with T1DM. Results. In preclinical trials, DPP-4 inhibitors improved the pathogenesis of T1DM. However, only a portion of the studies showed potential efficacy regarding clinical glycemic control and other clinical parameters. From this meta-analysis, pooled data from 5 randomized controlled trials revealed that the additional use of DPP-4 inhibitors resulted in a greater decrease in glycated hemoglobin A1c (HbA1c) levels (0.07%, 95% CI (−0.37%–0.23%)) than insulin monotherapy, although the decrease was not significant. A small decrease in postprandial glucose or insulin consumption was confirmed. Conclusion. Although DPP-4 inhibitors may be beneficial for T1DM, existing studies do not strongly support these positive effects in clinical practice. Further optimized clinical trials are needed.

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A dose–response meta-analysis between serum concentration of 25-hydroxy vitamin D and risk of type 1 diabetes mellitus

European Journal of Clinical Nutrition ◽

10.1038/s41430-020-00813-1 ◽

2020 ◽

Author(s):

Yilin Hou ◽

An Song ◽

Yuxin Jin ◽

Qiuyang Xia ◽

Guangyao Song ◽

...

Keyword(s):

Diabetes Mellitus ◽

Vitamin D ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Dose Response ◽

Meta Analysis ◽

Cochrane Library ◽

25 Hydroxy Vitamin D ◽

Meta Regression

AbstractIt remains debatable whether vitamin D plays any role as a risk factor for type 1 diabetes mellitus (T1DM). We have summarized the effect of circulating 25-hydroxy vitamin D [25(OH)D] concentration on the risk of developing T1DM via a dose–response meta-analysis. We undertook a database search on PubMed, Embase, and Cochrane Library from inception to January 2020. A meta-analysis based on random-effects model was applied. Subgroup analysis and meta-regression were performed to inspect the source of heterogeneity. Dose–response data were examined using the generalized least squares trend estimation method. This study was registered with the PROSPERO (ID: CRD42020166174). In total, 16 studies including 10,605 participants (3913 case patients) were included. The pooled odds ratios (OR) and 95% confidence intervals (95% CI) for the highest versus the lowest 25(OH)D concentration was 0.39 (0.27, 0.57), with a high heterogeneity (I2 = 76.7%, P < 0.001). Meta-regression analysis identified latitude (P = 0.02), adjustment for gender (P = 0.001), and 25(OH)D stratification (P < 0.001) as sources of heterogeneity. Furthermore, the nonlinear dose–response analysis determined the OR (95% CI) of T1DM to be 0.91 (0.90, 0.93) per 10 nmol/L increase in the 25(OH)D concentration. A ‘U’-shaped association was found between serum 25(OH)D concentration and risk of T1DM. The present study highlights the significant inverse association between the circulating 25(OH)D concentration and the risk of T1DM.

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Subclinical Atherosclerosis in Patients With Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis

Angiology ◽

10.1177/0003319718787366 ◽

2018 ◽

Vol 70 (2) ◽

pp. 141-159 ◽

Cited By ~ 6

Author(s):

Peng Wang ◽

Yuan-Yuan Xu ◽

Tian-Tian Lv ◽

Shi-Yang Guan ◽

Xiao-Mei Li ◽

...

Keyword(s):

Diabetes Mellitus ◽

Systematic Review ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Meta Analysis ◽

Subclinical Atherosclerosis ◽

Random Effect Model ◽

Current Evidence ◽

Cochrane Library

Cardiovascular (CV) risk in type 1 diabetes mellitus (T1DM) is increased. In this study, we evaluated the differences in major markers of CV risk between patients with T1DM and healthy controls by a systematic review and meta-analysis. Literature from PubMed, EMBASE, and The Cochrane Library comparing CV risk markers between patients with T1DM and controls was obtained. The overall standard mean differences (SMDs) of carotid intima–media thickness (cIMT), endothelium-dependent flow-mediated dilation (FMD%), carotid-femoral pulse wave velocity (cf-PWV), and glyceryl trinitrate-mediated dilatation (GTN%) with its 95% confidence interval (CI) between patients with T1DM and control groups were calculated using fixed-effect or random-effect model. Heterogeneity was evaluated using the Cochran Q and I2 statistics. The results showed that patients with T1DM had a significantly greater cIMT (SMD: 0.89; 95% CI, 0.69-1.09; P < .001), significantly lower FMD% (SMD: −1.45%; 95% CI, −1.74 to −1.17; P < .001), significantly increased cf-PWV (SMD: 0.57; 95% CI, 0.03-1.11; P < .001), and significantly decreased GTN% (SMD: −1.11; 95% CI, −1.55 to −0.66; P < .001) than controls. Our results support the current evidence for an elevated CV burden in patients with T1DM and affirm the clinical utility of markers of subclinical atherosclerosis in the management of these patients.

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Telemetric Interventions offer new Opportunities managing Type 1 Diabetes Mellitus: A systematic meta-analysis (Preprint)

10.2196/preprints.20270 ◽

2020 ◽

Author(s):

Claudia Eberle ◽

Stefanie Stichling

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Real Time ◽

Meta Analysis ◽

Current Evidence ◽

Positive Effects ◽

Meta Review ◽

Hba1c Levels

BACKGROUND The prevalence of Diabetes mellitus (DM) increases rapidly worldwide. At the same time technological advances offer new opportunities for a better disease management targeting type 1 diabetes mellitus (T1DM) patients. Telemetry, the remote acquisition of patient data via a telecommunication system, is a promising field of application of Electronic Health (eHealth), and quickly growing in importance. OBJECTIVE We summarized the current evidence for the effectiveness of telemetric approaches in T1DM management. This systematic meta-review examined different types of interventions of the technologies used in communication between health care professionals and patients as well as their key outcomes. METHODS We performed a systematic search in Web of Science Core Collection, EMBASE, Cochrane Library, MEDLINE via PubMed, and CINAHL databases in April 2020 with regard to the effectiveness of telemetric interventions in T1DM patients. We classified the interventions in four categories according to the technology used: (1) “real-time video communication” (2) “real-time audio communication” (3) “asynchronous communication” and (4) “combined forms of communication” (real-time and asynchronous). We considered various study designs such as systematic reviews (SRs), clinical trials (CT), meta-analysis (MAs), randomized controlled trials (RCTs), and focussed on key outcomes. RESULTS We identified n=23 eligible publications in total: RCTs (n=15), SRs and MAs (n=5), cohort studies (n=2), and one qualitative publication (n=1). Of n=17 studies, nine (52,9%) indicated a significant decline in HbA1c levels. 60,8% (n=14) reported overall (mildly) positive effects in terms of telemetric interventions by addressing all measured outcomes. Moreover, “asynchronous interventions” were most successful for patients diagnosed with T1DM, but no technology was clearly superior. However, there were many nonsignificant results, not sustained effects, and in some studies, the control group benefited from telemetric support or increased frequency of contacts. CONCLUSIONS This systematic meta-review shows significant reduction in HbA1c levels and reports overall positive effects of telemedical interventions in T1DM. However, the whole potential of telemetric approaches in T1DM management should be analysed in detail in further studies since the evidence seems to be inconsistent regarding different outcomes and type of interventions. CLINICALTRIAL A systematic Meta-Review.

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