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Meta-Analysis
. 2021 Mar 3;11(1):11.
doi: 10.1038/s41387-021-00152-5.

Effects of alpha-glucosidase-inhibiting drugs on acute postprandial glucose and insulin responses: a systematic review and meta-analysis

Marjan Alssema  1   2 , Carolien Ruijgrok  2 , Ellen E Blaak  3 , Léonie Egli  4 , Pierre Dussort  5 , Sophie Vinoy  6 , Jacqueline M Dekker  2 , M Denise Robertson  7
Affiliations
Meta-Analysis

Effects of alpha-glucosidase-inhibiting drugs on acute postprandial glucose and insulin responses: a systematic review and meta-analysis

Marjan Alssema et al. Nutr Diabetes. .

Abstract

Background/objectives: Despite considerable literature supporting the potential health benefits of reducing postprandial glucose (PPG), and insulin (PPI) exposures, the size of a clinically relevant reduction is currently unknown. We performed a systematic review and meta-analysis to quantify effects of alpha-glucosidase-inhibiting (AGI) drugs on acute PPG and PPI responses.

Methods: We searched EMBASE and MEDLINE until March 13, 2018 for controlled studies using AGI drugs together with a standardized carbohydrate load or mixed meal. The mean incremental PPG and PPI levels were calculated as outcomes. Meta-analyses, stratified by diabetes state, were performed by using random effects models.

Results: The 66 included publications comprised 127 drug-control comparisons for PPG, and 106 for PPI, mostly testing acarbose or miglitol. The absolute effects on PPG were larger among individuals with diabetes (-1.5 mmol/l mean PPG [95% CI -1.9, -1.1] by acarbose, and -1.6 [-1.9, -1.4] by miglitol) as compared to individuals without diabetes (-0.4 [95% CI -0.5, -0.3] by acarbose, and -0.6 [-0.8, -0.4] by miglitol). Relative reductions in PPG by both drugs were similar for diabetic and non-diabetic individuals (43-54%). Acarbose and miglitol also significantly reduced mean PPI, with absolute and relative reductions being largest among individuals without diabetes.

Conclusions: The present meta-analyses provide quantitative estimates of reductions of PPG and PPI responses by AGI drugs in diabetes and non-diabetic individuals. These data can serve as benchmarks for clinically relevant reductions in PPG and PPI via drug or diet and lifestyle interventions.

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Conflict of interest statement

M.A. was an employee of Unilever, a manufacturer of consumer food products; L.E. was an employee of Nestec SA; and SV is an employee of Mondēlez International R&D; E.E.B., J.M.D., P.D., C.R. and M.D.R. have nothing to disclose. This work was conducted by an expert group of the European branch of the International Life Sciences Institute, ILSI Europe. The Dietary Carbohydrates Task Force coordinated this publication. Industry members of this task force are listed on ILSI Europe’s website at http://ilsi.eu/task-forces/nutrition/dietary-carbohydrates/. Experts are not paid for the time spent on this work; however, the non-industry members within the expert group were offered support for travel and accommodation costs from the Dietary Carbohydrates Task Force to attend meetings to discuss the manuscript and a small compensatory honorarium with the option to decline. The expert group carried-out the work that is collecting/analyzing data/information and writing the scientific paper separate to other activities of the task force. The research reported is the result of a scientific evaluation in line with ILSI Europe’s framework to provide a precompetitive setting for public–private partnership. ILSI Europe facilitated scientific meetings and coordinated the overall project management and administrative tasks related to the completion of this work. The opinions expressed herein and the conclusions of this publication are those of the authors and do not necessarily represent the views of ILSI Europe nor those of its member companies or any regulatory authority.

Figures

Fig. 1
Fig. 1. PRISMA flow diagram of literature search: PRISMA=preferred reporting items for systematic reviews and meta-analyses.
PRISMA flow-diagram.
See this image and copyright information in PMC

References

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