Meta‐analysis of head‐to‐head clinical trials comparing incretin‐based glucose‐lowering medications and basal insulin: An update including recently developed glucagon‐like peptide‐1 ( GLP ‐1) receptor agonists and the glucose‐dependent insulinotropic polypeptide/ GLP ‐1 receptor co‐agonist tirzepatide
Authors' conclusion
Recently introduced, highly effective IBGLMs were superior to basal insulin treatment, reinforcing the recommendation that IBGLMs should be considered as the first injectable treatment for most patients with type 2 diabetes.
Study context
- Population
- Patients with T2D
- Participants
- 11,843 patients20 studies47 arms
- Comparison
- Injectable incretin-based glucose-lowering medications vs basal insulin
- Outcome
- Difference in HbA1c reduction vs baseline between pooled IBGLMs and their subgroups vs basal insulin (mean differences)
Methodological detailshead-to-head comparisons, fixed-effects (pooled) and random-effects (subgroups) meta-analysis, PubMed search (April 2022)
- Head-to-head comparisons
- Fixed-effects (pooled) and random-effects (subgroups) meta-analysis
- PubMed search (April 2022)
Pooled result
As reported in the abstract
HbA1c reduction
Each group vs basal insulinEstimate (CI)
IBGLMsgreater HbA1c lowering with IBGLMs; fixed-effects
difference 0.48 %(0.45–0.52)
Long-acting GLP-1 RAspooled
ΔHbA1c −0.25 %(−0.38 to −0.11)
Tirzepatidepooled doses
ΔHbA1c −0.90 %(−1.06 to −0.75)
Further pooled results
| Outcome | Difference (kg) (CI) | |
|---|---|---|
| Body weightIBGLMsvs Basal insulinSignificantly lower with all IBGLM subgroups | −4.6 (−4.7 to −4.4) | |
| Body weightTirzepatidevs Basal insulin | −12.0 (−13.8 to −10.1) | |
| −20−10010Difference, kg (linear scale) |
Blood pressure and lipids
- Incretin-based glucose-lowering medications (IBGLMs) significantly reduced blood pressure and improved lipid variables
Risk of bias
- Risk of bias was low
Safety
Hypoglycaemia and GI adverse events
- IBGLMs significantly reduced hypoglycaemia
- IBGLMs associated with more nausea, vomiting, diarrhoea and study medication discontinuation
Original publication
Meta‐analysis of head‐to‐head clinical trials comparing incretin‐based glucose‐lowering medications and basal insulin: An update including recently developed glucagon‐like peptide‐1 ( GLP ‐1) receptor agonists and the glucose‐dependent insulinotropic polypeptide/ GLP ‐1 receptor co‐agonist tirzepatide. Diabetes Obes Metab. Published 8 February 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →