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Cited by 14Diabetes Management and ResearchDiabetes Treatment and ManagementDiabetes Management and Education

The effect of sodium-glucose cotransporter 2 inhibitors as an adjunct to insulin in patients with type 1 diabetes assessed by continuous glucose monitoring: a systematic review and meta-analysis

Li, Mengnan, Liu, Zi'ang, Yang, Xifeng, Zhang, Jiaxin, Han, Minmin, Zhang, Yi, Liu, Yunfeng·2023·Journal of Diabetes and its Complications
DOI 10.1016/j.jdiacomp.2023.108632
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Abstract

Aims Patients undergoing insulin-based therapy for type 1 diabetes often experience poor glycemic control characterized by significant fluctuations. This study was undertaken to analyze the effect of sodium-glucose cotransporter 2 inhibitors (SGLT2Is), as an adjunct to insulin, on time in range (TIR) and glycemic variability in patients with type 1 diabetes, using continuous glucose monitoring (CGM). In addition, we examined which type of SGLT2I yielded a superior effect compared to others. Methods We conducted a comprehensive search of PubMed, EMBASE, the Cochrane Library, Web of Science, and clinical trial registry websites, retrieving all eligible randomized clinical trials (RCTs) published up until February 2023. We analyzed the mean TIR, mean amplitude of glucose excursions (MAGE), mean daily glucose (MDG), diabetic ketoacidosis (DKA), standard deviation (SD), total insulin dose, and severe hypoglycemia to evaluate the efficacy and safety of SGLT2Is. A random-effects model was also employed. Results This study encompassed 15 RCTs. The meta-analysis revealed that the use of SGLT2Is as an adjuvant therapy to insulin led to a significant increase in TIR (MD = 10.78, 95%CI = 9.33-12.23, I 2 = 42 %, P 2 = 0 %, P 2 = 19 %, P 2 = 48 %, P 2 = 32 %, P 2 = 16 %). In addition, the subgroup analyses based on the type of SGLT2Is revealed that dapagliflozin might exhibit greater efficacy compared to other SGLT2Is across most outcomes. Conclusions SGLT2Is exhibited a positive effect on…

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  • SGLT2 inhibitors have been studied in clinical trials in people with type 1 diabetes, and results showed improvements in A1C, reduced body weight, and improved blood pressure; however, SGLT2 inhibitor use in type 1 diabetes was associated with an increased rate of DKA.

    “Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been studied in clinical trials in people with type 1 diabetes, and results showed improvements in A1C, reduced body weight, and improved blood pressure (78); however, SGLT2 inhibitor use in type 1 diabetes was associated with an increased rate of DKA (79).”

    From 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2025 (2025) · cites this paper as [79]

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Authors
Li, M., Liu, Z., Yang, X., Zhang, J., Han, M., Zhang, Y., & Liu, Y.
Affiliations
Shanxi Medical University (CN)
Corresponding author
  • Zhang, Yi
  • Liu, Yunfeng
ORCID
Venue
Journal of Diabetes and its Complications
Publisher
Elsevier BV
Published
2023-12
Volume
37
Issue
12
Pages
108632
ISSN
  • 0891-6632 (ISSN-L)
  • 1056-8727
DOI
10.1016/j.jdiacomp.2023.108632
OpenAlex
W4387849400
Cited by
14
References
5
Citations by year
2026: 3 · 2025: 9 · 2024: 2
FWCI
0.51
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Journal of Diabetes and its Complications (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords
SGLT2 inhibitors, type 1 diabetes, insulin therapy, adjunctive therapy, glycemic variability, time in range, continuous glucose monitoring, insulin dose reduction, diabetic ketoacidosis, hypoglycemia, glycemic control, insulin pump therapy
MeSH terms
Sodium-Glucose Transporter 2 Inhibitors, Benzhydryl Compounds, Diabetes Mellitus, Type 1, Glucose, Glucosides, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Sodium, Randomized Controlled Trials as Topic, Diabetic Ketoacidosis, Insulin, Regular, Human

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