Sodium–Glucose Cotransporter 2 Inhibitors for Type 2 Diabetes: A Systematic Review and Meta-analysis
Abstract
Background Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a new class of antidiabetic drugs. Purpose To assess the efficacy and safety of SGLT2 inhibitors in adults with type 2 diabetes. Data sources MEDLINE, EMBASE, and the Cochrane Library from inception through April 2013 without language restrictions; regulatory authorities' reports; and gray literature. Study selection Randomized trials comparing SGLT2 inhibitors with placebo or other medication for type 2 diabetes. Data extraction Three reviewers extracted or checked data for study characteristics, outcomes of interest, and risk of bias, and 3 reviewers summarized strength of evidence using the Grading of Recommendations Assessment, Development and Evaluation approach. Data synthesis Sodium-glucose cotransporter 2 inhibitors were compared with placebo in 45 studies (n = 11 232) and with active comparators in 13 studies (n = 5175). They had a favorable effect on hemoglobin A1c level (mean difference vs. placebo, -0.66% [95% CI, -0.73% to -0.58%]; mean difference vs. active comparators, -0.06% [CI, -0.18% to 0.05%]). Sensitivity analyses incorporating unpublished data showed similar effect estimates. Compared with other agents, SGLT2 inhibitors reduced body weight (mean difference, -1.80 kg [CI, -3.50 to -0.11 kg]) and systolic blood pressure (mean difference, -4.45 mm Hg [CI, -5.73 to -3.18 mm Hg]). Urinary and genital tract infections were more common with SGLT2 inhibitors (odds ratios, 1.42 [CI, 1.06 to 1.90] an…
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In a prior meta-analysis of 45 RCTs, SGLT2i conferred modest lowering of HbA1c (mean difference 0.7%), lowering of systolic blood pressure (4.5 mm Hg), and weight loss (-1.8 kg).
“In a prior meta-analysis of 45 RCTs, SGLT2i conferred modest lowering of HbA1c (mean difference 0.7%), lowering of systolic blood pressure (4.5 mm Hg), and weight loss ( -1.8 kg). 104”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [104]
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- Authors
- Vasilakou, D., Karagiannis, T., Athanasiadou, E., Mainou, M., Liakos, A., Bekiari, E., Sarigianni, M., Matthews, D. R., & Tsapas, A.
- Affiliations
- Aristotle University of Thessaloniki (GR)
- From Aristotle University Thessaloniki, Thessaloniki, Greece, and University of Oxford, Oxford, United Kingdom.
- ORCID
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2013-08-20
- Volume
- 159
- Issue
- 4
- Pages
- 262-274
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2072040765
- Cited by
- 911
- References
- 8
- Citations by year
- 2026: 30 · 2025: 48 · 2024: 54 · 2023: 55 · 2022: 62 · 2021: 70 · 2020: 85 · 2019: 69 · 2018: 71 · 2017: 89 · 2016: 107 · 2015: 94 · 2014: 67 · 2013: 8 · 2012: 1
- FWCI
- 13.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute for Health and Care Research (NF-SI-0508-10272)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- SGLT2 inhibitors, type 2 diabetes, dapagliflozin, empagliflozin, HbA1c, glycemic control, weight loss, systolic blood pressure, urinary tract infection, genital tract infection, hypoglycemia, bladder cancer, breast cancer, cardiovascular outcomes, drug safety, antidiabetic drugs, risk of bias
- MeSH terms
- Blood Pressure, Diabetes Mellitus, Type 2, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Weight Loss, Selection Bias, Risk Assessment, Sodium-Glucose Transporter 2
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