Details

Autor(en) / Beteiligte

• Zhu, Xingyun
• Lin, Chu
• Li, Li
• Hu, Suiyuan
• Cai, Xiaoling
• Ji, Linong

Titel

SGLT2i increased the plasma fasting glucagon level in patients with diabetes: A meta-analysis

Ist Teil von

• European journal of pharmacology, 2021-07, Vol.903, p.174145-174145, Article 174145

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2021

Link zum Volltext

Quelle

Elsevier ScienceDirect Journals Complete

Beschreibungen/Notizen

• Increased glucagon level was hypothesized to participate in the ketoacidosis associated with sodium-glucose co-transporter 2 inhibitors (SGLT2i) treatment. However, the effect of SGLT2i on glucagon remains controversial. Hence, we conducted this meta-analysis to assess the overall effect of SGLT2i treatment on plasma fasting glucagon level in patients with diabetes. PubMed/MEDLINE, Embase, and Cochrane databases were searched for studies published before August 2020. Clinical trials in patients with type 1 diabetes mellitus and type 2 diabetes mellitus with reports of glucagon changes before and after SGLT2i intervention were included. Eligible trials were analyzed by fixed-effect model, random effect model, and meta-regression analysis accordingly. In total, ten trials were included in this meta-analysis. Compared with the non-SGLT2i treatment group, SGLT2i treatment resulted in increased plasma fasting glucagon levels with significance (WMD, 8.35 pg/ml; 95% CI, 2.17–14.54 pg/ml, P＜0.01) in patients with diabetes mellitus. Besides, when compared with non-SGLT2i control group, the insulin level decreased (WMD, −2.78 μU/ml; 95% CI, −5.11 to −0.46 μU/ml, P = 0.02) and ketone body level increased (WMD, 0.17 mmol/l; 95% CI, 0.09–0.25 mmol/l, P＜0.01) in patients with type 2 diabetes. In conclusion, our result indicated SGLT2i intervention would increase the plasma fasting glucagon level in patients with diabetes mellitus. The increase in plasma fasting glucagon level may be associated with reduced insulin level. The increased glucagon-insulin ratio after the use of SGLT2i may make diabetic patients susceptible to ketosis. •The use of SGLT2i would increase plasma fasting glucagon levels in patients with diabetes mellitus.•Patients with increased glucagon levels also had decreased insulin level and increased ketone body level.•The reduced insulin level after the use of SGLT2i may be associated with the increased glucagon level.•The increased glucagon-insulin ratio after the use of SGLT2i may make diabetic patients susceptible to ketosis.