5 years ago

Different intervention strategies for preventing type 2 diabetes mellitus in China: A systematic review and network meta-analysis of randomized controlled trials

Xiao-lin Tong, Jun Song, Xin-long Li, Xiao-wen Gou, Xi-yan Zhao, Yu-jiao Zheng, Shuo Feng, Lin-hua Zhao, Bing Pang, Qing-wei Li, Qing Ni, Xing Liao
Different strategies are increasingly used for early intervention on prediabetes in China, but the effects of these strategies on incident diabetes have not yet been confirmed. This study was to systematically assess the effects of different strategies on preventing diabetes, aimed at Chinese prediabetic subjects. Seven electronic databases were searched to identify eligible trials published from inception to Sep 20, 2016. Randomized controlled trials with a minimum follow-up duration of 6 months were included. Standard pairwise meta-analysis with a random-effects model and network meta-analysis with a frequentist framework were performed. Sixty-three studies with 11 intervention strategies were included. Compared with placebo, all strategies, except for lipid-affecting drugs and sitagliptin, reduced the incident diabetes with different levels of effectiveness, ranging from 0.18 (95%CI 0.12, 0.27) to 0.39 (95%CI 0.20, 0.75). Ranking probability analysis indicated that metformin and β-cell simulating drugs reduced the risk of diabetes most, with probabilities of 87.4 and 81%, respectively. Ethnicity and cultural factors should be considered for diabetes prevention. However, most of the included trials were of poor methodological quality; the results should be interpreted with caution.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/dom.13121

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