Efficacy Of Sodium-glucose Cotransporter2(SGLT2) Inhibitor Treatment For Diabetic Patients Achieving HbA1c <7.0%: Systematic Review And Meta-analysis

Objective: To summarize the English-language literature on theefficacy reaching the target of HbA1c <7%and safety of Sodium-glucosecotransporter2(SGLT2) inhibitor in patients with type2diabetes (T2DM).Method: The MEDLINE, EMBASE, Pubmed, the Cochrane Library,Web of Science databases were searched from inception through July2013for systematic reviews.2reviewers using standardized protocols performedserial abstraction. Quality assessment used the Cochrane risk of bias score.An I2of more than50%was considered to indicate heterogeneity, and therandom-effects model was adopted. Statistical significance was assumed atthe P≤0.05level.Results:17RCTs met the selection criteria, which included5941participants. Summary analyses showed that compared with placebo,SGLT2inhibitors led to a statistically increase in achieving the goal ofHbA1c <7%in both short-(≤26weeks OR2.49,95%CI1.90to3.24,P<0.05) and long-term treatment (>26weeks OR=2.22,95%CI1.47to 3.34, P<0.05) compared with placebo, with weight loss (≤26weeks WMD=-1.72kg,95%CI-1.96to-1.48, P<0.05;>26weeks WMD=-2.30kg，95%CI-2.78to-1.81, P<0.05), low risk of hypoglycemia (≤26weeksRR=1.45,95%CI0.97to2.16, P>0.05;>26weeks RR1.05,95%CI0.89to1.23, P>0.05), a mild elevated risk of urinary tract infection withshort-term therapy. SGLT2inhibitors were also associated with asignificant increased risk for development of genital infections (≤26weeks,RR3.88,95%CI2.64to5.69, P<0.05;>26weeks RR3.24,95%CI1.95to5.37, P<0.05).Conclusions: A greater proportion of type2diabetic patients canachieve the HbA1c target <7%with SGLT2inhibitors compared to placebo,with weight loss, low hypoglycemic risk, but with an increased risk fordevelopment of genital infections.