Meta‐analysis and critical review on the efficacy and safety of alpha‐glucosidase inhibitors in Asian and non‐Asian populations

Aims To evaluate the efficacy and safety of alpha glucosidase inhibitors (AGI) in Asian and non-Asian type 2 diabetic patients. Materials and Methods Studies were identified through a literature search of MEDLINE, EMBASE, and other databases until December 2016. All statistical analyses were conducted in Review Manager statistical software by computing the weighted mean difference (WMD) or odds ratio (OR) and 95% confidence interval (CI). Results A total of 67 studies were included. 1) AGI vs placebo: Compared with placebo, AGI treatment led to greater decrease in HbA1c, fasting plasma glucose (FPG), and postprandial plasma glucose (PPG). No significant difference was observed in HbA1c change, FPG change, PPG change, or incidence of hypoglycemia between Asian and non-Asian patients. 2) AGI vs active controls: In Asian patients, AGI treatment showed a lower reduction in HbA1c compared with dipeptidyl peptidase 4 (DPP-4) inhibitors and sulfonylurea (SU). In non-Asian patients, AGI treatment showed a lower reduction in HbA1c compared with thiazolidinedione (TZD). No significant difference was observed in HbA1c change and body weight change when comparing AGI with other oral hypoglycemic agents (OHAs) between Asian and non-Asian patients. Conclusions The effects of AGI treatment on glycemic control and body weight reduction were superior to placebo without an increased incidence of hypoglycemia, whereas with an increased incidence of gastrointestinal discomforts. The hypoglycemic effects of AGI were comparable between Asian and non-Asian patients. This article is protected by copyright. All rights reserved.