Sodium‐glucose co‐transporter 2 inhibitors in addition to insulin therapy for management of type 2 diabetes mellitus: A meta‐analysis of randomized controlled trials

Given inconsistent trial results of sodium‐glucose cotransporter 2 ( SGLT2 ) inhibitors in addition to insulin therapy for treating type 2 diabetes mellitus ( T2DM ), a meta‐analysis was performed to evaluate the efficacy and safety of this combination for T2DM by searching available randomized trials from PubMed , Embase, CENTRAL and ClinicalTrials.gov . Our meta‐analysis included seven eligible placebo‐controlled trials involving 4235 patients. Compared with placebo, SGLT2 inhibitor treatment was significantly associated with a mean reduction in HbA1c of −0.56%, fasting plasma glucose of −0.95 mmol/L, body weight of −2.63 kg and insulin dose of −8.79 IU , but an increased risk of drug‐related adverse events by 36%, urinary tract infections by 29% and genital infections by 357%. No significant increase was observed in risk of overall adverse events [risk ratio ( RR ), 1.00], serious adverse events ( RR , 0.90), adverse events leading to discontinuation ( RR , 1.16), hypoglycaemia events ( RR , 1.07) and severe hypoglycaemia events ( RR , 1.24). No diabetic ketoacidosis events were reported. Further studies are needed to establish optimal combination type and dose.