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Evaluating a combination therapy for the treatment of type 2 diabetes

Posted by Medivizor on Jan 30, 2020 in Diabetes mellitus |


In a nutshell

This study evaluated the safety and effectiveness of a combination treatment between sodium-glucose cotransporter 2 (SGLT) inhibitors and glucagon-like peptide 1 (GLP1) receptor agonists for patients with Type 2 diabetes (T2D). This study concluded that combination treatment improved blood glucose control and reduced weight loss for these patients.

Some background

As T2D progresses, more intense treatment may be required. Many patients with T2D eventually need second-line anti-diabetic drugs for better blood glucose control. Often, multiple drugs may be recommended together, in a combination treatment.

SGLT2 inhibitors help the kidneys remove glucose from the body through the urine. GLP-1 agonists also help lower blood glucose levels by increasing insulin secretion from the pancreas. Whether combining these two agents is safe and effective for treating T2D is unclear.

Methods & findings

This study analyzed the results of 11 different studies. A total of 1604 patients with T2D or obesity were included. Patients received either a SGLT2-GLP1 combination treatment or a control-placebo treatment. Patients were followed for an average of 18 to 52 weeks.

Fasting plasma glucose is the level of glucose in the blood before eating a meal. Combination treatment significantly lowered fasting plasma glucose levels by 1.28 mmol/L compared to control-placebo. On average, combination treatment also decreased HbA1c levels (average blood glucose over the past 3 months) by 1.32%.

Combination treatment significantly reduced body weight by 0.93 kg compared to placebo. On average, systolic blood pressure (blood pressure during a heartbeat) also decreased between 0.93 and 1.17 mmHg.

Overall, side effects were similar between the combination treatment group and the control-placebo group. Combination treatment was associated with a risk of urinary tract infections, gut side effects, and heart side effects. 

The bottom line

This study concluded that SGLT2 inhibitors and GLP-1 agonists together helped improve blood glucose control and lower body weight for patients with T2D.

The fine print

This study looked back in time to analyze data, so these conclusions may be limited. More studies are needed to confirm these results.

Original Title :

The efficacy and safety of combinations of SGLT2 inhibitors and GLP-1 receptor agonists in the treatment of type 2 diabetes or obese adults: a systematic review and meta-analysis.

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