{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:42:46Z","timestamp":1772160166686,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>In type 2 diabetes, glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101RAs) in combination with metformin show better efficacy than metformin alone. Nevertheless, the reactions of different ethnic groups, especially Asian and non\u2010Asian populations, are still controversial. To give clinical medication usage an evidence\u2010based foundation, this meta\u2010analysis examined GLP\u20101RAs' safety and efficacy when combined with metformin in the treatment of type 2 diabetes mellitus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Up to January 2025, systematic searches for randomised controlled trials were carried out in PubMed, Embase, the Cochrane Library, SinoMed and Wanfang comparing GLP\u20101RA\/metformin combination versus metformin alone in type 2 diabetes, with subgroup analyses for Asian versus non\u2010Asian cohorts. RevMan version 5.3 was used for analyses, and the Cochrane tools for risk of bias were used for quality assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      This meta\u2010analysis comprised 11 papers in total (6 Asian trials: 750 people; 5 non\u2010Asian trials: 1096 people). After treatment of GLP\u20101RAs combined with metformin, the Asian group showed greater improvement in glycosylated haemoglobin (HbA1c) (weighted mean differences [WMD], \u22121.09; 95% confidence intervals [CI], \u22121.48 to \u22120.71; subgroup heterogeneity:\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200977.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) and weight (WMD, \u22124.16; 95% CI \u22126.11 to \u22122.22; subgroup heterogeneity:\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200989.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) with a lower gastrointestinal (GI) events risk (relative risks, 0.76; 95% CI, 0.47 to 1.22; subgroup heterogeneity:\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200993.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.00001). There were no racial variations in fasting glucose levels (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.78) or hypoglycaemia (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.16).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This meta\u2010analysis suggested potential ethnic variations in the treatment combining GLP\u20101RAs with metformin, with Asian populations achieving superior HbA1c reduction and weight loss alongside better GI tolerance.<\/jats:p>\n                  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