Anti-diabetic agents for prevention of type 2 diabetes mellitus in people with pre-diabetes: a systematic review and network meta-analysis protocol

Introduction Type 2 diabetes mellitus (T2DM) is a substantial health problem worldwide. Pre-diabetic state is associated with increased risk for the development of diabetes. There are various pharmacological therapies with glucose-lowering activity for diabetes prevention. Of those, most are being c...

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Main Authors: Jiabin Liu, Hai Zeng, Guoxin He, Wenbin Fu, Xianzhe Wang, Lijin Huang, Rui Ma, Baile Ning
Format: Article
Language:English
Published: BMJ Publishing Group 2019-10-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/10/e029073.full
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author Jiabin Liu
Hai Zeng
Guoxin He
Wenbin Fu
Xianzhe Wang
Lijin Huang
Rui Ma
Baile Ning
author_facet Jiabin Liu
Hai Zeng
Guoxin He
Wenbin Fu
Xianzhe Wang
Lijin Huang
Rui Ma
Baile Ning
author_sort Jiabin Liu
collection DOAJ
description Introduction Type 2 diabetes mellitus (T2DM) is a substantial health problem worldwide. Pre-diabetic state is associated with increased risk for the development of diabetes. There are various pharmacological therapies with glucose-lowering activity for diabetes prevention. Of those, most are being compared with placebo instead of active agents. The relative effects and safety of different glucose-lowering drugs still remain uncertain. To address this gap, we will conduct a systematic review and network meta-analysis (NMA) to evaluate comparative efficacy and safety of glucose-lowering agents for T2DM prevention in patients with pre-diabetes.Methods and analysis PubMed, the Cochrane library and Embase will be searched from inception to December 2019 for relevant randomised controlled trials (RCTs) that examined anti-diabetic drugs for diabetes prevention in patients with pre-diabetes. Two reviewers working independently will screen titles, abstracts and full papers. Data extraction will also be completed by two independent authors. The primary outcome will be the incidence of T2DM in patients with pre-diabetes at baseline. Secondary outcomes will include the achievement of normoglycaemia, all-cause mortality, cardiovascular mortality and hypoglycaemic event. Pairwise meta-analysis and NMA will be conducted for each outcome using a frequentist random-effects model. Additionally, subgroup analyses will also be performed. The comparison-adjusted funnel plot will be used to assess publication bias. The overall quality of evidence will be rated with the Grading of Recommendations Assessment, Development and Evaluation framework. Data analysis will be conducted using Stata V.14.0.Ethics and dissemination Ethics approval is not required. We plan to submit the results of this study to a peer-review journal.PROSPERO registration number CRD42019119157.
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spelling doaj-art-9811fa2a26a8469293a77caceb8540012025-08-20T01:55:39ZengBMJ Publishing GroupBMJ Open2044-60552019-10-0191010.1136/bmjopen-2019-029073Anti-diabetic agents for prevention of type 2 diabetes mellitus in people with pre-diabetes: a systematic review and network meta-analysis protocolJiabin Liu0Hai Zeng1Guoxin He2Wenbin Fu3Xianzhe Wang4Lijin Huang5Rui Ma6Baile Ning73 Department of Anesthesiology, Weill Cornell Medicine, New York, NY, United States2 The First Affiliated Hospital of Jinan University, Guangzhou, China2 The First College of Guangzhou University of Chinese Medicine, Guangzhou, China6 Department of Acupuncture and Moxibustion, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China1 The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China1 The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, ChinaGuangdong Institute of Gastroenterology, The Sixth Affiliated Hospital,Sun Yat-sen University, Guangzhou, Guangdong, China3 Department of Acupuncture and Moxibustion, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, ChinaIntroduction Type 2 diabetes mellitus (T2DM) is a substantial health problem worldwide. Pre-diabetic state is associated with increased risk for the development of diabetes. There are various pharmacological therapies with glucose-lowering activity for diabetes prevention. Of those, most are being compared with placebo instead of active agents. The relative effects and safety of different glucose-lowering drugs still remain uncertain. To address this gap, we will conduct a systematic review and network meta-analysis (NMA) to evaluate comparative efficacy and safety of glucose-lowering agents for T2DM prevention in patients with pre-diabetes.Methods and analysis PubMed, the Cochrane library and Embase will be searched from inception to December 2019 for relevant randomised controlled trials (RCTs) that examined anti-diabetic drugs for diabetes prevention in patients with pre-diabetes. Two reviewers working independently will screen titles, abstracts and full papers. Data extraction will also be completed by two independent authors. The primary outcome will be the incidence of T2DM in patients with pre-diabetes at baseline. Secondary outcomes will include the achievement of normoglycaemia, all-cause mortality, cardiovascular mortality and hypoglycaemic event. Pairwise meta-analysis and NMA will be conducted for each outcome using a frequentist random-effects model. Additionally, subgroup analyses will also be performed. The comparison-adjusted funnel plot will be used to assess publication bias. The overall quality of evidence will be rated with the Grading of Recommendations Assessment, Development and Evaluation framework. Data analysis will be conducted using Stata V.14.0.Ethics and dissemination Ethics approval is not required. We plan to submit the results of this study to a peer-review journal.PROSPERO registration number CRD42019119157.https://bmjopen.bmj.com/content/9/10/e029073.full
spellingShingle Jiabin Liu
Hai Zeng
Guoxin He
Wenbin Fu
Xianzhe Wang
Lijin Huang
Rui Ma
Baile Ning
Anti-diabetic agents for prevention of type 2 diabetes mellitus in people with pre-diabetes: a systematic review and network meta-analysis protocol
BMJ Open
title Anti-diabetic agents for prevention of type 2 diabetes mellitus in people with pre-diabetes: a systematic review and network meta-analysis protocol
title_full Anti-diabetic agents for prevention of type 2 diabetes mellitus in people with pre-diabetes: a systematic review and network meta-analysis protocol
title_fullStr Anti-diabetic agents for prevention of type 2 diabetes mellitus in people with pre-diabetes: a systematic review and network meta-analysis protocol
title_full_unstemmed Anti-diabetic agents for prevention of type 2 diabetes mellitus in people with pre-diabetes: a systematic review and network meta-analysis protocol
title_short Anti-diabetic agents for prevention of type 2 diabetes mellitus in people with pre-diabetes: a systematic review and network meta-analysis protocol
title_sort anti diabetic agents for prevention of type 2 diabetes mellitus in people with pre diabetes a systematic review and network meta analysis protocol
url https://bmjopen.bmj.com/content/9/10/e029073.full
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