Effects of proton pump inhibitors on glycemic control and incident diabetes: a systematic review and meta-analysis

CCH Peng, YK Tu, GY Lee, RHE Chang… - The Journal of …, 2021 - academic.oup.com
The Journal of Clinical Endocrinology & Metabolism, 2021academic.oup.com
Context Whether proton pump inhibitors (PPI) can improve glycemic control among
individuals with diabetes or decrease the risk of incident diabetes in the general population
is unclear. Objective To evaluate the impact of PPI therapy on glycemic control among
individuals with diabetes and the risk of diabetes among those without diabetes. Results
PubMed, Embase, Scopus, and ClinicalTrials. gov were searched from inception to
November 21, 2020. We included studies comparing glycosylated hemoglobin (HbA1c) or …
Context
Whether proton pump inhibitors (PPI) can improve glycemic control among individuals with diabetes or decrease the risk of incident diabetes in the general population is unclear.
Objective
To evaluate the impact of PPI therapy on glycemic control among individuals with diabetes and the risk of diabetes among those without diabetes.
Results
PubMed, Embase, Scopus, and ClinicalTrials.gov were searched from inception to November 21, 2020. We included studies comparing glycosylated hemoglobin (HbA1c) or fasting blood glucose (FBG) among individuals with diabetes treated with and without PPI therapy as an add-on to standard therapy. Studies evaluating the risk of incident diabetes among individuals taking PPI were assessed. We performed dual independent review, data extraction, and quality assessment. Weighted mean differences between groups or relative risks were imputed using random-effects models.
Results
Seven studies (n = 342) for glycemic control and 5 studies (n = 244 439) for risk of incident diabetes were included. Compared with standard therapy, add-on PPI was associated with a significant decrease in HbA1c (WMD, −0.36 %; 95% CI, −0.68 to −0.05; P = 0.025) and FBG (WMD, −10.0 mg/dL; 95% CI, −19.4 to −0.6; P = 0.037). PPI use did not reduce the risk of incident diabetes (pooled RR, 1.10; 95% CI, 0.89 to 1.34; P = 0.385).
Conclusion
Add-on PPI improved glycemic indices among individuals with diabetes but did not alter the risk of incident diabetes. The effects of PPI on glycemic control should be considered when prescribing antacids to patients with diabetes.
Oxford University Press
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