{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T08:55:15Z","timestamp":1775724915147,"version":"3.50.1"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,1,8]],"date-time":"2018-01-08T00:00:00Z","timestamp":1515369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2018,7]]},"abstract":"Abstract<\/jats:title>Aims\/Introduction<\/jats:title>We aimed to evaluate the efficacy and safety of pioglitazone (PIO<\/jats:styled-content>) and sodium\u2013glucose cotransporter 2 inhibitors (SGLT<\/jats:styled-content>2i) as additions to insulin therapy for the management of type 2 diabetes mellitus.<\/jats:p><\/jats:sec>Materials and Methods<\/jats:title>We searched PubMed, EMBASE<\/jats:styled-content>, the Cochrane Central Register of Controlled Trials and ClinicalTrials.gov through December 2016. Randomized controlled trials published in English that compared SGLT<\/jats:styled-content>2i plus insulin (SGLT<\/jats:styled-content>2i\/INS<\/jats:styled-content>) or PIO<\/jats:styled-content> plus insulin (PIO<\/jats:styled-content>\/INS<\/jats:styled-content>) with placebo plus insulin (PCB<\/jats:styled-content>\/INS<\/jats:styled-content>) in type 2 diabetes mellitus patients were included. We compared the efficacy and safety between SGLT<\/jats:styled-content>2i\/INS<\/jats:styled-content> and PIO<\/jats:styled-content>\/INS<\/jats:styled-content> indirectly.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 14 randomized controlled trials comparing 7,226 participants were included (8 SGLT<\/jats:styled-content>2i and 6 PIO<\/jats:styled-content> studies). SGLT<\/jats:styled-content>2i\/INS<\/jats:styled-content> achieved similar reductions in hemoglobin A1c (weighted mean difference [WMD<\/jats:styled-content>] \u22120.01% [\u22120.1\u00a0mmol\/mol], 95% confidence interval [CI<\/jats:styled-content>] \u22120.25 to 0.22% [\u22122.7 to \u22122.4\u00a0mmol\/mol]; P<\/jats:italic>\u00a0=\u00a00.896) and fasting plasma glucose (WMD<\/jats:styled-content> \u22120.90\u00a0mg\/dL<\/jats:styled-content>, 95% CI: \u221215.50 to 13.71\u00a0mg\/dL<\/jats:styled-content>; P<\/jats:italic>\u00a0=\u00a00.904), and a similar proportion of participants achieved hemoglobin A1c <7.0% (<53.0\u00a0mmol\/mol; relative risk 0.98, 95% CI: 0.73 to 1.33; P<\/jats:italic>\u00a0=\u00a00.917) as compared with the PIO<\/jats:styled-content>\/INS<\/jats:styled-content> group, with greater weight reduction (WMD<\/jats:styled-content> \u22124.54\u00a0kg, 95% CI<\/jats:styled-content>: \u22125.67 to \u22123.41\u00a0kg; P<\/jats:italic>\u00a0<\u00a00.001). PIO<\/jats:styled-content>\/INS<\/jats:styled-content> showed non\u2010significant trends toward a higher risk of hypoglycemia (relative risk 1.15, 95% CI<\/jats:styled-content>: 0.97 to 1.35; P<\/jats:italic>\u00a0=\u00a00.102) and higher reduction of total daily insulin doses (WMD<\/jats:styled-content> \u22122.45\u00a0IU<\/jats:styled-content>\/day, 95% CI<\/jats:styled-content>: \u22127.30 to 2.40\u00a0IU<\/jats:styled-content>\/day; P<\/jats:italic>\u00a0=\u00a00.438).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Both PIO<\/jats:styled-content> and SGLT<\/jats:styled-content>2i are feasible adjunctive oral agents to pre\u2010existing insulin therapy in individuals with inadequately controlled type 2 diabetes mellitus.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdi.12787","type":"journal-article","created":{"date-parts":[[2017,12,7]],"date-time":"2017-12-07T11:40:48Z","timestamp":1512646848000},"page":"882-892","source":"Crossref","is-referenced-by-count":9,"title":["Comparison between sodium\u2013glucose cotransporter 2 inhibitors and pioglitazone as additions to insulin therapy in type 2 diabetes patients: A systematic review with an indirect comparison meta\u2010analysis"],"prefix":"10.1111","volume":"9","author":[{"given":"Yun Kyung","family":"Cho","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ye\u2010Jee","family":"Kim","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Biostatistics Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu Mi","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung Eun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joong\u2010Yeol","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Woo Je","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4043-2396","authenticated-orcid":false,"given":"Chang Hee","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Asan Medical Center University of Ulsan College of Medicine Seoul 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