Systematic Review on Interaction Studies of Synthetic Antidiabetic Drugs and Herbal Therapies

Introduction: Considering that Alzheimer’s disease (AD) and diabetes mellitus share pathophysiological features and AD remains with no cure, antidiabetic drugs like intranasal insulin, glitazones, metformin, and liraglutide are being tested as a potential treatment. Objective: The aim of this systematic review was to assess the efficacy of antidiabetic drugs in patients with AD, mild cognitive impairment (MCI), or subjective cognitive complaints (SCCs). Cognition was studied as the primary outcome and modulation of AD biomarkers, and imaging was also assessed as a secondary outcome. Methods: We conducted a search in the electronic databases PubMed/MEDLINE, EMBASE, and Scopus seeking clinical trials evaluating the effect on cognition of antidiabetic drugs in patients with AD, MCI, or SCCs. Results: A total of 23 articles were found eligible. Intranasal regular insulin improved verbal memory in most studies, especially in apoE4− patients, but results in other cognitive domains were unclear. Detemir improved cognition after 2 months of treatment, but it did not after 4 months. Pioglitazone improved cognition in diabetic patients with AD or MCI in 3 clinical trials, but it is controversial as 2 other studies did not show effect. Metformin and liraglutide showed promising results, but further research is needed as just 2 clinical trials involved each of these drugs. Almost all drugs tested were shown to modulate AD biomarkers and imaging. Conclusions: Intranasal insulin, pioglitazone, metformin, and liraglutide are promising drugs that could be useful in the treatment of AD. However, many questions remain to be answered in future studies, so no particular antidiabetic drug can currently be recommended to treat AD.

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Efficacy and Safety Profile Evaluation of Acarbose Alone and in Association With Other Antidiabetic Drugs: A Systematic Review

Clinical Therapeutics ◽

10.1016/j.clinthera.2012.04.012 ◽

2012 ◽

Vol 34 (6) ◽

pp. 1221-1236 ◽

Cited By ~ 31

Author(s):

Giuseppe Derosa ◽

Pamela Maffioli

Keyword(s):

Systematic Review ◽

Safety Profile ◽

Antidiabetic Drugs ◽

Efficacy And Safety

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Genotoxic properties of hypoglycemic drugs (systematic review)

Ecological genetics ◽

10.17816/ecogen70691 ◽

2021 ◽

Vol 19 (3) ◽

pp. 219-240

Author(s):

Natalia V. Eremina ◽

Aliy K. Zhanataev ◽

Artem A. Lisitsyn ◽

Andrey D. Durnev

Keyword(s):

Systematic Review ◽

Antidiabetic Drugs ◽

Published Data ◽

Antimutagenic Activity

According to the literature genotoxic properties of about a half of hypoglycemic drugs have not been investigated in accordance with the recommended methodology, and studies of the mutagen-modifying activity of antidiabetic drugs are sporadic. Based on the available published data, it is impossible to conclude about either presence or absence of genotoxic / antigenotoxic potential of antidiabetic drugs. There is evidence of the antimutagenic activity of metformin; in relation to other drugs, studies of mutagen-modifying activity have not been carried out or are represented only by a few articles. Further study of the genotoxic properties of hypoglycemic drugs is required in accordance with modern approaches and requirements, as well as an assessment of their mutagen-modifying activity.

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Cardiovascular mortality and oral antidiabetic drugs: protocol for a systematic review and network meta-analysis

BMJ Open ◽

10.1136/bmjopen-2017-017644 ◽

2017 ◽

Vol 7 (11) ◽

pp. e017644

Author(s):

Rashmi Goyat ◽

James Douglas Thornton ◽

Xi Tan ◽

George A Kelley

Keyword(s):

Systematic Review ◽

Cardiovascular Mortality ◽

Observational Studies ◽

Meta Analysis ◽

Risk Of Bias ◽

Antidiabetic Drugs ◽

Assessment Instrument ◽

Haemoglobin A1c ◽

Cardiovascular Safety ◽

Coronary Syndrome

IntroductionCardiovascular diseases are the leading cause of morbidity and mortality among individuals with diabetes. Despite the beneficial effects of antidiabetic drugs (ADDs) in terms of lowering haemoglobin A1c, several ADDs have been shown to increase the risk of cardiovascular events. Given the high prevalence of cardiovascular disease among individuals with diabetes, it is important to weigh the benefits of ADDs against their cardiovascular safety. Therefore, the objective of the current study is to conduct a systematic review with network meta-analysis to compare the effects of different oral pharmacological classes of ADDs on cardiovascular safety.Methods and analysisRandomised clinical trials (RCTs) and observational studies published in English up to 31 January 2017, and which include direct and/or indirect evidence, will be included. Studies will be retrieved by searching four electronic databases and cross-referencing. Dual selection and abstraction of data will occur. The primary outcome will be cardiovascular mortality. Secondary outcomes will include all-cause mortality, new event of acute myocardial infarction, stroke (haemorrhagic and ischaemic), hospitalisation for acute coronary syndrome and urgent revascularisation procedures. Risk of bias will be assessed using the Cochrane Risk of Bias assessment instrument for RCTs and the Strengthening the Reporting of Observational Studies in Epidemiology instrument for observational studies. Network meta-analysis will be performed using multivariate random-effects meta-regression models. The surface under the cumulative ranking curve will be used to provide a hierarchy of ADDs that increase cardiovascular mortality.DisseminationThe results of this study will be presented at a professional conference and submitted to a peer-reviewed journal.PROSPERO registration numberCRD42017051220.

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