Efficacy and Safety of Ranolazine in Diabetic Patients: A Systematic Review and Meta-analysis

2017 ◽  
Vol 52 (5) ◽  
pp. 415-424 ◽  
Author(s):  
Xiaofang Zeng ◽  
Yinyin Zhang ◽  
Jianhui Lin ◽  
Haikuo Zheng ◽  
Jie Peng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Serum Glucose ◽  
Major Adverse Cardiovascular Events ◽  
Diabetic Patients ◽  
Efficacy And Safety ◽  
End Points ◽  
Patients With Diabetes ◽  
Persistent Hyperglycemia

Background:Recent studies have discovered that the antiangina agent ranolazine exerts a glucometabolic effect. Objective: This systematic review and meta-analysis aimed to further understand the efficacy and safety profile of ranolazine in patients with diabetes. Methods: Randomized controlled trials (RCTs) were searched in PubMed, Cochrane, and EMBASE databases and in ClinicalTrials.gov up to July 2017. Efficacy end points were defined as the change in hemoglobin A1C (A1C) and fasting serum glucose (FSG) levels. Safety end points included the incidence of hypoglycemia, persistent hyperglycemia, and major adverse cardiovascular events (MACE). Sensitive and subgroup analyses were also conducted. Results: Seven RCTs with 4461 diabetic patients were selected. Compared with placebo, the use of ranolazine significantly reduced the levels of A1C (weighted mean difference [WMD] = −0.49%; 95% CI = −0.58 to −0.40; P < 0.00001) and FSG (WMD = −6.70 mg/dL; 95% CI = −11.87 to −1.52; P = 0.01). No significant differences were observed in the rates of hypoglycemia (relative risk [RR] = 1.17; 95% CI = 0.76 to 1.80; P = 0.47), persistent hyperglycemia (RR = 0.78; 95% CI = 0.47 to 1.31; P = 0.35), and MACE (RR = 0.65; 95% CI = 0.32 to 1.32; P = 0.23). Conclusion: Ranolazine exerts a positive effect on glucose control and is a well-tolerated agent for patients with diabetes.

scholarly journals Urinary N-Acetyl-β-d-glucosaminidase (uNAG) as an Indicative Biomarker of Early Diabetic Nephropathy in Patients with Diabetes Mellitus (T1DM, T2DM): A Systematic Review and Meta-Analysis

Diabetology ◽  
2021 ◽  
Vol 2 (4) ◽  
pp. 272-285
Author(s):  
Arlinda R. Driza ◽  
Georgia V. Kapoula ◽  
Pantelis G. Bagos
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Diabetic Nephropathy ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Diabetic Patients ◽  
Pool Data ◽  
Patients With Diabetes ◽  
Pubmed Search ◽  
Renal Tubular

Diabetic nephropathy (DN) is the main cause of chronic kidney disease in patients with type 1 (T1DM) and type 2 diabetes mellitus (T2DM). Renal tubular lysosomal enzyme activities like N-acetyl-β-d-glucosaminidase (NAG) have been shown to increase in patients developing DN. The aim of this systematic review and meta-analysis is to evaluate the diagnostic accuracy of NAG, as a preventional biomarker in the early stages of DN in patients with diabetes mellitus. Two impartial reviewers conducted a complete PubMed search until July 2021. A 2 × 2 contingency table was created for each trial and sensitivity and specificity were estimated using a bivariate random effects model. To pool data and estimate the area under the curve (AUC), the hierarchical summary ROC (hsROC) approach was utilized. Deek’s test was used to estimate publication bias. The meta-analysis included 21 studies that evaluated 2783 patients with T1DM and T2DM, as well as 673 healthy individuals. The AUC of urinary NAG (uNAG) ranged from 0.69 (95% CI: 0.65–0.73) to 0.89 (95% CI: 0.86–0.92). According to the results, NAG in urine can be considered as a potential and effective biomarker for predicting DN in diabetic patients (T1DM, T2DM).

scholarly journals Association of Preadmission Metformin Use and Prognosis in Patients With Sepsis and Diabetes Mellitus: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Yuanzhe Li ◽  
Huayan Zhao ◽  
Yalin Guo ◽  
Yongtao Duan ◽  
Yanjun Guo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Lactic Acid ◽  
Serum Creatinine ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Significant Difference ◽  
Patients With Diabetes ◽  
Newcastle Ottawa Scale

Background and AimA growing body of evidence suggests that preadmission metformin use could decrease the mortality of septic patients with diabetes mellitus (DM); however, the findings remain controversial. Therefore, this meta-analysis was conducted on available studies to confirm the relationship between preadmission metformin use and mortality in patients with sepsis and DM.MethodsA comprehensive search of the PubMed, Embase, and Cochrane Library databases was performed for studies published before August 8, 2021. Observational studies assessing the correlation between metformin use and mortality in patients with sepsis and DM were considered eligible studies. We used the Newcastle–Ottawa Scale (NOS) to assess the outcome quality of each included article. Furthermore, the odds ratios (ORs) and 95% confidence intervals (CIs) were analyzed using the inverse variance method with random effects modeling.ResultsEleven articles including 8195 patients were analyzed in this meta-analysis. All the included articles were scored as low risk of bias. Our results showed that preadmission metformin use had a lower mortality rate (OR, 0.74; 95% CIs, 0.62–0.88, P &lt; 0.01) in patients with sepsis and DM. Surprisingly, there was no statistically significant difference in the levels of serum creatinine (weighted mean difference (WMD), 0.36; 95% CIs, −0.03–0.75; P = 0.84) and lactic acid (WMD, −0.16; 95% CIs, −0.49–0.18; P = 0.07) between preadmission metformin use and non-metformin use.ConclusionsThis study is the most comprehensive meta-analysis at present, which shows that preadmission metformin use may reduce mortality and not increase the levels of serum creatinine and lactic acid in adult patients with sepsis and DM. Therefore, these data suggest that the potential efficacy of metformin could be assessed in future clinical studies.Systematic Review Registrationhttps://inplasy.com/?s=INPLASY2021100113, identifier INPLASY2021100113.

scholarly journals The efficacy and safety of liraglutide in the obese, non-diabetic individuals: a systematic review and meta-analysis

2019 ◽  
Vol 19 (3) ◽  
pp. 2591-2599
Author(s):  
Pei Zhang ◽  
Yu Liu ◽  
Yuan Ren ◽  
Jie Bai ◽  
Guangzhen Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Weight Loss ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
End Points ◽  
Safe Treatment ◽  
Randomised Control Trials ◽  
Safety Assessments ◽  
Treatment Of Obesity

Background: Liraglutide has been shown to improve glucose tolerance and lose weight in individuals with type 2 diabetes. To date, no meta-analysis of liraglutide’s safety and efficacy in individuals without diabetes has been conducted.Objectives: The aim of this study is to carry out a meta-analysis to assess the efficacy and safety of liraglutide in the obese, non-diabetic individuals.Methods: A literature review was performed to identify all published randomised control trials (RCT) of liraglutide for the treatment of obesity in non-diabetic individuals. The search included the following databases: EMBASE, MEDLINE and the Cochrane Controlled Trials Register.Results: We included five publications involving a total of 4,754 patients that compared liraglutide with placebo and found that liraglutide to be an effective and safe treatment for weight loss in individuals without diabetes. Primary efficacy end points: mean weight loss (MD = -5.52, 95% CI = -5.93 to -5.11, p<0.00001); lost more than 5% of body weight (OR = 5.46, 95% CI=3.57 to 8.34, p<0.00001) and key secondary efficacy end points: SBP decreased (the MD = -2.56, 95% CI = -3.28 to -1.84, p<0.00001). Safety assessments included the proportion of individuals who were withdrawn due to AE (OR = 2.85, 95% CI= 0.84 to 9.62, p=0.009), and nausea indicated that liraglutide was well tolerated. Conclusion: This systematic review and meta-analysis indicates that liraglutide to be an effective and safe treatment for weight loss in the obese, non-diabetic individuals.Keywords: liraglutide, weight loss, meta-analysis.

scholarly journals Efficacy and Safety of Tirzepatide in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Phase II/III Trials

2021 ◽  
Vol 14 (10) ◽  
pp. 991
Author(s):  
Akshaya Srikanth Bhagavathula ◽  
Kota Vidyasagar ◽  
Wubshet Tesfaye
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Body Weight ◽  
Receptor Agonist ◽  
Meta Analysis ◽  
Serum Glucose ◽  
Efficacy And Safety ◽  
Fasting Serum

Tirzepatide is a novel once-a-week dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, currently under trial to assess glycemic efficacy and safety in people with type 2 diabetes. A systematic review and meta-analysis were conducted to investigate the efficacy of tirzepatide on glycated hemoglobin (HbA1c, %), fasting serum glucose (mg/dL), and body weight (kg) in patients with uncontrolled type 2 diabetes (HbA1c > 7.0%). Mean changes for efficacy and proportions (safety) with corresponding 95% confidence intervals (CIs) were used to provide pooled estimates. A total of four randomized controlled trials, comprising 2783 patients of whom 69.4% (n = 1934) were treated with 5 mg (n = 646), 10 mg (n = 641), or 15 mg (n = 647) of tirzepatide, were compared to the placebo (n = 192) or the selective GLP-1 receptor agonist (n = 523). The pooled analysis showed that tirzepatide treatment resulted in a greater lowering of the HbA1c (−1.94%, 95% CI: −2.02 to −1.87), fasting serum glucose (−54.72 mg/dL, 95% CI: −62.05 to −47.39), and body weight (−8.47, 95% CI: −9.66 to −7.27). We also found that improvement in the HbA1c levels was still maintained at weeks 26 and 40 from the long-term trials. As for safety, only 3% experienced hypoglycemia, and 4% (95% CI: 2 to 6) experienced serious adverse events, while the discontinuation of therapy percentage was 7% (95% CI: 5 to 8). Tirzepatide significantly improved glycemic control and body weight and had an acceptable safety profile, indicating that it is an effective therapeutic option for glucose-lowering in patients with type 2 diabetes mellitus.

scholarly journals MANAGEMENT OF ENDOCRINE DISEASE: Suicide risk in patients with diabetes: a systematic review and meta-analysis

2017 ◽  
Vol 177 (4) ◽  
pp. R169-R181 ◽  
Author(s):  
Bin Wang ◽  
Xiaofei An ◽  
Xiaohong Shi ◽  
Jin-an Zhang
Keyword(s):  
Systematic Review ◽  
Type 1 Diabetes ◽  
Incidence Rate ◽  
Suicide Risk ◽  
Meta Analysis ◽  
Diabetic Patients ◽  
Effective Strategies ◽  
Patients With Diabetes ◽  
Diabetes Patients

Background Previous studies investigating the risk of suicide in diabetes patients reported controversial findings. We did a systematic review and meta-analysis to comprehensively estimate the risk and incidence rate of suicide in diabetic patients. Methods PubMed, EMBASE and PsycINFO were searched for eligible studies. Random-effects meta-analysis was used to calculate the relative risk (RR) and the incidence rate of suicide in diabetes patients. We also calculated the proportion of deaths attributable to suicide among diabetes patients. Results 54 studies were finally included, including 28 studies on the suicide risk associated with diabetes, 47 studies on the incidence rate of suicide and 45 studies on the proportion of deaths attributable to suicide. Meta-analysis showed that diabetes could significantly increase the risk of suicide (RR = 1.56; 95% CI: 1.29–1.89; P < 0.001). Subgroup analysis showed that the RR of suicide associated with type 1 diabetes was 2.25 (95% CI: 1.50–3.38; P < 0.001). The pooled incidence rate of suicide in patients with diabetes was 2.35 per 10 000 person-years (95% CI: 1.51–3.64). The pooled proportions of long-term deaths attributable to suicide in type 1 diabetes patients and type 2 diabetes patients were 7.7% (95% CI: 6.0–9.8) and 1.3% (95% CI: 0.6–2.6), respectively. Conclusion This meta-analysis suggests that diabetes can significantly increase the risk of suicide. Suicide has an obvious contribution to mortality in diabetic patients, especially among type 1 diabetes patients. Effective strategies to decrease suicide risk and improve mental health outcomes in diabetes patients are needed.

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