Summary of findings 4. Summary of findings: alpha‐glucosidase inhibitors.
| Combinations of insulin and alpha‐glucosidase inhibitors compared with insulin monotherapy for diabetes mellitus | |||||
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Patient: participants with type 2 diabetes mellitus Settings: mostly secondary care outpatients Intervention: alpha‐glucosidase inhibitors plus insulin Comparison: insulin monotherapy | |||||
| Outcomes | Insulin monotherapy | Insulin plus alpha‐glucosidase inhibitors | No of participants (studies) | Quality of the evidence (GRADE) | Comments |
| All‐cause mortality | See comment | See comment | See comment | See comment | Not investigated |
| Diabetes‐related mortality | See comment | See comment | See comment | See comment | Not investigated |
| Diabetes‐related morbidity | See comment | See comment | See comment | See comment | Not investigated |
| Health‐related quality of life | See comment | See comment | See comment | See comment | Not investigated |
| Patient satisfaction | See comment | See comment | See comment | See comment | Not investigated |
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Adverse events: a. mild hypoglycaemia (% of participants) Follow‐up: 24 weeks to 12 months b. weight gain (kg) Follow‐up: 24 weeks to 12 months |
a. range 0%‐35% b. The mean weight gain across control groups ranged from +0.7 kg to +3.6 kg |
a. range 0%‐39% b. the mean weight gain in the intervention groups was0.5 kg lower (1.2 kg lower to 0.3 kg higher) |
a. 583 (4) b. 241 (2) |
a) ⊕⊝⊝⊝lowa b) ⊕⊝⊝⊝lowa |
a. serious hypoglycaemic episodes were rare |
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HbA1c, change from baseline (%) Follow‐up: 3 to 6 months |
The mean change in HbA1c across control groups ranged from ‐1.1% to 0.04% | The mean change in HbA1c in the intervention groups was 0.4% lower (0.5% lower to 0.2% lower) | 448 (3) | ⊕⊝⊝⊝lowa | ‐ |
| CI: confidence interval; HbA1c: glycosylated haemoglobin A1c | |||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | |||||
aDowngraded by two levels because of unclear or high risk of bias in several risk of bias domains, indirectness and imprecision