1.Regulatory effect of liraglutide on hypoglycemia in patients with type 1 diabetes mellitus:a meta-analysis
Yan WANG ; Fangxin JIN ; Minne LI ; Rujiang LI ; Xueli ZHANG
China Pharmacy 2024;35(23):2908-2914
OBJECTIVE To systematically evaluate the regulatory effect of liraglutide on hypoglycemia in patients with type 1 diabetes mellitus (T1DM) and provide evidence for the prevention and control of hypoglycemia in the clinical treatment of T1DM. METHODS Electronic databases including The Cochrane Library, PubMed, Embase, Web of Science, China Biology Medicine Disc (CBM), CNKI, Wanfang database, and VIP database were searched from the inception of the databases to June 30, 2023. The clinical randomized controlled trials (RCTs) of liraglutide on hypoglycemia in T1DM patients were screened according to inclusion and exclusion criteria. Data extraction, grouping, and subgroup meta-analysis were conducted for the included studies. RESULTS A total of 11 RCTs involving 1 685 patients were ultimately included. Meta-analysis results showed that treatment with 1.2 mg liraglutide could reduce the frequency of hypoglycemia in patients with T1DM [OR=0.81, 95%CI (0.74, 0.88), P<0.01], while treatment with 1.8 mg liraglutide could increase the frequency of hypoglycemia [OR=1.33, 95%CI (1.23, 1.44), P<0.01]. The effect of liraglutide on hypoglycemia in patients with T1DM was not correlated with the duration of hypoglycemia [MD= -0.29, 95%CI (-1.21, 0.63), P=0.53], and did not increase the incidence of severe hypoglycemia in these patients [OR=0.87, 95%CI (0.57, 1.33), P=0.53]. Liraglutide could reduce the levels of glycated hemoglobin [MD=-1.39, 95%CI (-2.65, -0.13), P=0.03], weight [MD=-4.28, 95%CI (-5.01, -3.55), P<0.01], and body mass index [MD=-1.20, 95%CI (-1.80, -0.60), P<0.01] in them. CONCLUSIONS Liraglutide has a bidirectional regulatory effect on hypoglycemia in patients with T1DM, which is correlated with the dose of liraglutide. An appropriate dose of liraglutide (1.2 mg) can inhibit hypoglycemia in these patients, while an increased dose of liraglutide (1.8 mg) can promote hypoglycemia in them.