{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:30:37Z","timestamp":1791199837597,"version":"4.2.0"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,7,20]],"date-time":"2024-07-20T00:00:00Z","timestamp":1721433600000},"content-version":"vor","delay-in-days":201,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72074011"],"award-info":[{"award-number":["72074011"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Diabetes Research"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> The objective was to evaluate the efficacy of the combination of Glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101 RAs), dipeptidyl peptidase\u20104 inhibitors (DPP\u20104i), and sodium\u2010glucose cotransporter 2 inhibitor (SGLT\u20102i) in the treatment of Type 2 diabetes with poor efficacy of basic insulin and metformin\/sulfonylurea by umbrella review.<\/jats:p><jats:p><jats:bold>Materials and Methods:<\/jats:bold> Forming the data of publication of each database through 13 September 2022, PubMed, EMBASE, and Cochrane Library were surveyed.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> A total of seven meta\u2010analyses were included in the umbrella review. The combination of GLP\u20101 RA (WMD \u22123.41 [\u22125.61, \u22121.21], <jats:italic>p<\/jats:italic> = 0.002), SGLT\u20102i (WMD \u22125.34 [\u22129.56, \u22121.13], <jats:italic>p<\/jats:italic> = 0.013), and DPP\u20104i (WMD \u22125.56 [\u22127.39, \u22123.73], <jats:italic>p<\/jats:italic> \u2264 0.001) can significantly reduce HbA1c levels, respectively. The combination of GLP\u20101 RA (WMD \u22121.55 [\u22122.92, \u22120.18], <jats:italic>p<\/jats:italic> = 0.027), SGLT\u20102i (WMD \u22122.96 [\u22126.68, 0.77], <jats:italic>p<\/jats:italic> = 0.12), and DPP\u20104i (WMD \u22122.05 [\u22122.82, \u22121.28], <jats:italic>p<\/jats:italic> \u2264 0.001) can significantly reduce fasting plasma glucose (FPG) levels, respectively. The combination of GLP\u20101 RA (WMD \u22123.24 [\u22125.14, \u22121.34], <jats:italic>p<\/jats:italic> &lt; 0.001) can significantly reduce body weight of Type 2 diabetes mellitus (T2DM). The dose of basic insulin in diabetes patients after combined use of GLP\u20101 RA (WMD \u22122.74 [\u22124.26, \u22121.22], <jats:italic>p<\/jats:italic> \u2264 0.001) was significantly reduced. The combination use of GLP\u20101 RAs (OR 1.28 [1.05, 1.56], <jats:italic>p<\/jats:italic> = 0.017) increases the risk of hypoglycemia.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> The combination of GLP\u20101 RAs, DPP\u20104i, and SGLT\u20102i can effectively lower HbA1c and FPG in T2DM patients who have poor therapeutic effects on basic insulin combined with metformin\/sulfonylureas, respectively. Compared to placebo, GLP\u20101 RAs can significantly reduce body weight and basic insulin dosage, while DPP\u20104i and SGLT\u20102i have a lower risk of hypoglycemia.<\/jats:p><jats:p><jats:bold>Trial Registration:<\/jats:bold><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.crd.york.ac.uk\/PROSPERO\/\">CRD42023410345<\/jats:ext-link>.<\/jats:p>","DOI":"10.1155\/2024\/8145388","type":"journal-article","created":{"date-parts":[[2024,7,20]],"date-time":"2024-07-20T08:49:22Z","timestamp":1721465362000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Comparison of GLP\u20101 Receptor Agonists, SGLT\u20102 Inhibitors, and DPP\u20104 Inhibitors as an Add\u2010On Drug to Insulin Combined With Oral Hypoglycemic Drugs: Umbrella Review"],"prefix":"10.1155","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8746-518X","authenticated-orcid":false,"given":"Sanbao","family":"Chai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5732-2682","authenticated-orcid":false,"given":"Yapin","family":"Niu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6055-529X","authenticated-orcid":false,"given":"Fengqi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9791-8093","authenticated-orcid":false,"given":"Shanshan","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1562-0603","authenticated-orcid":false,"given":"Zhirong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4334-6805","authenticated-orcid":false,"given":"Feng","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,20]]},"reference":[{"key":"e_1_2_10_1_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-0413"},{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2020.0065"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14552"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.13225"},{"key":"e_1_2_10_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12841"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-022-01676-5"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-020-0399-8"},{"key":"e_1_2_10_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/XEB.0000000000000055"},{"key":"e_1_2_10_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j4008"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_10_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2017.05.006"},{"key":"e_1_2_10_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"e_1_2_10_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-0716-1566-9_8"},{"key":"e_1_2_10_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2016.03.011"},{"key":"e_1_2_10_15_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-1957"},{"key":"e_1_2_10_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2818"},{"key":"e_1_2_10_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.12787"},{"key":"e_1_2_10_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.12764"},{"key":"e_1_2_10_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-22443-1"},{"key":"e_1_2_10_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2019.06.009"},{"key":"e_1_2_10_21_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc24-S009"},{"key":"e_1_2_10_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqaa435"},{"key":"e_1_2_10_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/0145721720965464"},{"key":"e_1_2_10_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-021-05592-3"},{"key":"e_1_2_10_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-021-05577-2"},{"key":"e_1_2_10_26_2","doi-asserted-by":"publisher","DOI":"10.3390\/nu12092722"},{"key":"e_1_2_10_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-019-04968-x"},{"key":"e_1_2_10_28_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.825417"}],"container-title":["Journal 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