Alpha-glucosidase inhibitors for type 2 diabetes mellitus

摘要: Background Alpha-glucosidase inhibitors such as acarbose or miglitol, have the potential to improve glycemic control in type 2 diabetes mellitus. The true value of these agents, especially relation related mortality and morbidity, has never been investigated a systematic literature review meta-analysis. Objectives To assess effects alpha-glucosidase patients with mellitus. Search methods We searched Cochrane Library, MEDLINE, EMBASE, Current Contents, LILACS, databases ongoing trials, reference lists reviews on topic we contacted experts manufacturers for additional trials. Selection criteria Randomised controlled trials at least 12 weeks duration comparing inhibitor monotherapy any other intervention that included one following outcomes: mortality, quality life, control, lipids, insulin levels, body weight, adverse events. Data collection analysis Two reviewers read all abstracts, assessed extracted data independently. Discrepancies were resolved by consensus judgement third reviewer. A statistician checked entrance database. We attempted contact authors clarification. Main results We 41 (8130 participants), 30 acarbose, seven trial voglibose three compared different inhibitors. Study was 24 most cases only two studies lasted amply longer than year. found few morbidity life. Acarbose had clear effect placebo: glycated haemoglobin -0.8% (95% confidence interval -0.9 -0.7), fasting blood glucose -1.1 mmol/L -1.4 -0.9), post-load -2.3 -2.7 -1.9). not dose-dependent. decreasing no clinically relevant lipids weight. Adverse mostly gastro-intestinal origin dose dependent. Compared sulphonylurea, decreased levels -24.8 pmol/L -43.3 -6.3) -133.2 -184.5 -81.8) respectively caused more effects. Authors' conclusions It remains unclear whether influence diabetes. Conversely, they significant but statistically These are less sure when used duration. dosages higher 50 mg TID offer hemoglobin instead. lower an inferior profile regarding effects.