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- Title
Differences in the HbA1c-lowering efficacy of glucagon-like peptide-1 analogues between Asians and non-Asians: a systematic review and meta-analysis.
- Authors
Kim, Y. G.; Hahn, S.; Oh, T. J.; Park, K. S.; Cho, Y. M.
- Abstract
Aims To compare the HbA1c-lowering efficacy of glucagon-like peptide-1 ( GLP-1) analogues between Asians and non-Asians with type 2 diabetes. Methods We searched randomized controlled trials from MEDLINE, EMBASE, LILACS, CENTRAL and . Studies described in English were included if the treatment duration was 12 weeks or more, information about ethnicity and baseline HbA1c values were available and a GLP-1 analogue was compared with a placebo. For the ethnic comparison, we divided the studies into Asian-dominant studies (≥50% Asian participants) and non-Asian-dominant studies (<50% Asian participants). Results Among the 837 searched studies, 15 trials were included for the meta-analysis. The weighted mean difference of HbA1c with GLP-1 analogues was −1.16% [95% confidence interval ( CI) −1.48, −0.85] in the Asian-dominant studies and −0.83% (95% CI −0.97, −0.70) in the non-Asian-dominant studies. The between-group difference was −0.32% (95% CI −0.64, −0.01; p = 0.04). The relative risk ( RR) with 95% CIs for achieving the target HbA1c ≤7.0% tended to be greater in the Asian-dominant studies [ RR 5.7 (3.8, 8.7)] than in the non-Asian-dominant studies [ RR 2.8 (2.4, 3.3)]. Body weight changes were similar between the two groups. Hypoglycaemia tended to be more common in Asian-dominant studies ( RR 2.8 [2.3, 3.5]) than in non-Asian-dominant studies ( RR 1.5 [1.2, 1.8]), but severe hypoglycaemia was very rare in both groups. Conclusion GLP-1 analogues lower HbA1c more in Asian-dominant studies than in non-Asian-dominant studies. Further studies are warranted to explore the potential mechanisms of the ethnic difference.
- Subjects
HYPOGLYCEMIA; ASIANS; GLUCAGON-like peptide 1; HEMOGLOBINS; SYSTEMATIC reviews; TYPE 2 diabetes
- Publication
Diabetes, Obesity & Metabolism, 2014, Vol 16, Issue 10, p900
- ISSN
1462-8902
- Publication type
Article
- DOI
10.1111/dom.12293