Comparative efficacy and safety of Glucagon‐like pepetide‐1 receptor agonists with metformin in Asian versus non‐Asian patients with type 2 diabetes: A systematic review and meta‐analysis

Li, W; Huang, L; Wang, R; Peng, P; Song, A; Zeng, Y; Zhang, Z

doi:10.1111/dom.70084

Type 2 & other diabetes

Comparative efficacy and safety of Glucagon‐like pepetide‐1 receptor agonists with metformin in Asian versus non‐Asian patients with type 2 diabetes: A systematic review and meta‐analysis

Diabetes Obes MetabPublished 11 Sep 2025Systematic review and meta-analysis of randomised controlled trials

Pooled result · HbA1cResultWMD −1.09 95% CI −1.48 to −0.71

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Authors' conclusion

This meta-analysis suggested potential ethnic variations in the treatment combining GLP-1RAs with metformin, with Asian populations achieving superior HbA1c reduction and weight loss alongside better GI tolerance.

Study context

Population: Patients with T2D in RCTs comparing GLP-1 RA/metformin combination vs metformin alone11 papers
Participants: 750 vs 1,096

Comparison: GLP-1 RA + metformin vs metformin alone, Asian vs non-Asian
Asiann = 750
Non-Asiann = 1,096reference
Outcome: HbA1c

Methodological detailssubgroup analyses for Asian vs non-Asian cohorts

Subgroup analyses for Asian vs non-Asian cohorts

Pooled result

As reported in the abstract

WMD

−1.09

95% CI −1.48 to −0.71

P < 0.05

Asianvs Non-Asian

WMD −1.09 (95% CI −1.48 to −0.71); P < 0.05

Further pooled results

Outcome	← Lower with asian ←→ Higher with asian →	WMD (95% CI)	P value
Weight	−10−505	−4.16 (−6.11 to −2.22)	P < 0.05
	−10−505Difference (linear scale)

Outcome	P value
Fasting glucoseNo racial variation	P = 0.78

Weight: greater improvement in Asian group; subgroup heterogeneity I2 = 89.5%

Safety

Outcome	← Lower risk with asian ←→ Higher risk with asian →	RR (95% CI)	P value
GI events	0.512	0.76 (0.47–1.22)	P < 0.00001
	0.512Relative risk (log scale)

Outcome	P value
HypoglycaemiaNo racial variation	P = 0.16

Gastrointestinal (GI) events: lower GI events risk in Asian group; subgroup heterogeneity I2 = 93.7%

Original publication

Comparative efficacy and safety of Glucagon‐like pepetide‐1 receptor agonists with metformin in Asian versus non‐Asian patients with type 2 diabetes: A systematic review and meta‐analysis. Diabetes Obes Metab. Published 11 September 2025. doi:10.1111/dom.70084

Read the original article ↗

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