{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T09:03:52Z","timestamp":1785229432002,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Endocrino Diabet &amp; Metabol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The glucocorticoids are increasingly being used in the management of different autoimmune conditions and cancers. Our meta\u2010analysis aims to leverage metformin's potential to reverse the metabolic complications of glucocorticoids by activating AMP\u2010activated protein kinase (AMPK), while sparing their anti\u2010inflammatory benefits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Cochrane Library, trial registries and Google Scholar were searched from inception to June 2025 for Randomized Controlled Trials (RCTs) and observational studies comparing metformin and placebo to prevent metabolic side effects of glucocorticoid therapy in non\u2010diabetic patients. After screening by two independent reviewers according to PRISMA guidelines, four studies involving 187 patients were analysed using the random\u2010effects model in RevMan 5.4.1, and mean differences (MD) were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Preventive metformin administration during glucocorticoid treatment is superior to placebo with respect to glycaemic control as shown by statistically significant reduction in fasting blood glucose [MD\u2009=\u2009\u22120.60 (95% CI: \u22120.86 to \u22120.34)], HOMA index of insulin resistance [MD\u2009=\u2009\u22120.53 (95% CI: \u22120.97 to \u22120.08)], LDL levels [MD\u2009=\u2009\u22120.20 (95% CI: \u22120.40 to \u22120.00)] and total cholesterol [MD\u2009=\u2009\u22120.27 (95% CI: \u22120.54 to \u22120.01)]. However, our study failed to show significant improvement in area under the curve glucose (mmol\/L\u2009\u00d7\u2009min) after challenge [MD\u2009=\u2009\u2212176.66 (95% CI: \u2212415.42, 62.11)], basal metabolic rate (BMR) [MD\u2009=\u200951.99 (95% CI: \u221253.08, 157.07)], HDL [MD\u2009=\u2009\u22120.04 (95% CI: \u22120.13, 0.05)], insulin levels [MD\u2009=\u2009\u22122.26 (95% CI: \u22125.90, 1.38)], triglycerides [MD\u2009=\u2009\u22120.15 (95% CI: \u22120.42, 0.13)] and body weight [MD\u2009=\u2009\u22120.93 (95% CI: \u22122.29 to 0.44)].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While glucocorticoids remain essential in various clinical contexts, their detrimental effects on glucose metabolism are well documented. This study supports metformin as a promising preventive treatment in non\u2010diabetic patients receiving systemic glucocorticoid therapy. Improvement in insulin sensitivity and resulting fasting glucose levels may offset glucocorticoid\u2010exacerbated inflammation. Further studies are needed to address long\u2010term outcomes, including adiposity, bone metabolism, appetite, liver function and muscle wasting, as well as to identify possible predictors of therapeutic response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>International Prospective Register of Systematic Reviews (PROSPERO) registration number: CRD420251104082<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/edm2.70235","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T04:20:48Z","timestamp":1782188448000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of Metformin in Prevention of Glucocorticoid\u2010Induced Hyperglycemia in Patients Without Diabetes: A Meta\u2010Analysis"],"prefix":"10.1002","volume":"9","author":[{"given":"Sana","family":"Murtaza","sequence":"first","affiliation":[{"name":"Punjab Medical College (New: Faisalabad Medical University)  Faisalabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"Murtaza","sequence":"additional","affiliation":[{"name":"Punjab Medical College (New: Faisalabad Medical University)  Faisalabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Usama","family":"Yasin","sequence":"additional","affiliation":[{"name":"Punjab Medical College (New: Faisalabad Medical University)  Faisalabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amna","family":"Shahid","sequence":"additional","affiliation":[{"name":"Punjab Medical College (New: Faisalabad Medical University)  Faisalabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maira","family":"Shahid","sequence":"additional","affiliation":[{"name":"Punjab Medical College (New: Faisalabad Medical University)  Faisalabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Maaz Bin","family":"Rehan","sequence":"additional","affiliation":[{"name":"AdventHealth Sebring  Sebring Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7121-8574","authenticated-orcid":false,"given":"Fateen","family":"Ata","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6705-2030","authenticated-orcid":false,"given":"Muhammad Sohaib","family":"Asghar","sequence":"additional","affiliation":[{"name":"AdventHealth Sebring  Sebring Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2370-9368","authenticated-orcid":false,"given":"Mohammed Mahmmoud Fadelallah","family":"Eljack","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences University of Bakhtalruda  Ad Douiem Sudan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"issue":"5","key":"e_1_2_11_2_1","first-page":"719","article-title":"Short\u2010Term Metformin Protects Against Glucocorticoid\u2010Induced Toxicity in Healthy Individuals: A Randomized, Double\u2010Blind, Placebo\u2010Controlled Trial","volume":"48","author":"Thierry S.","year":"2025","journal-title":"Diabetes Care"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnad016"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP08331.RAR"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2011.26.2.264"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-013-2991-0"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnaa023"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ando.2023.05.002"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-16-0653"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2700"},{"issue":"6","key":"e_1_2_11_11_1","first-page":"670","article-title":"Metformin Combined With Glucocorticoid in the Treatment of SLE Patients With IGT","volume":"25","author":"Guinv L. 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