Type: dissertation
Study designs: Systematic Review, Meta-Analysis
Abstract: Type 2 diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from lack of insulin action.The mechanism for a lack of insulin action has two components: impaired insulin secretion and decreased insulin sensitivity (insulin resistance) in organs on which insulin acts.Both are components of the pathogenesis of type 2 diabetes.In general, insulin resistance plays a key role causing type 2 diabetes in Caucasians, whereas impaired insulin secretion plays a key role in the development of type 2 diabetes in East Asians.Several systematic reviews and meta-analyses have been conducted including an analysis to investigate the difference between ethnic groups in glucose lowering efficacy of dipeptidyl peptidase-4 (DPP-4) inhibitors.However, no consistent result has been found to date.Thus, in this first research, we performed a systematic review and meta-analysis of randomized controlled studies and conducted meta-regression analyses to assess the correlation between the glucose-lowering efficacy of DPP-4 inhibitors in patients with type 2 diabetes and potential factors including ethnicity of study subjects and study regions; in particular, Japanese were dealt separately from other Asians.The finding of the first research suggested that a higher baseline Hemoglobin A1c (HbA1c), studies in Japanese subjects, and studies conducted in Japan are factors of greater efficacy of DPP-4 inhibitors on weighted mean difference (WMD) in the change of HbA1c from baseline.As for the sodium glucose co-transporter-2 (SGLT-2) inhibitor, systematic reviews and meta-analysis to investigate the difference in efficacy and safety of SGLT-2 inhibitors between different ethnic groups considering the pathophysiology has not been conducted so far.The reason might be its insulin independent mechanism of action.i Table of Contents iii List of Tables iv List of Figures v Abbreviations vi Over 76 Weeks in Patients With Type 2 Diabetes.
Author: NAGAKI-FUJITA, Kayo
Institution: Kitasato University
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7144954348