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- W2810366714 abstract "Placebo was defined as any therapy that is used for its nonspecific psychological and physiologic effect but has no specific pharmacologic impact on the condition being treated. Besides medication therapies, studies have found that the optimal dietary approach as well as physical activity and education are useful to control hyperglycemia in patients with type 2 diabetes (T2DM). The aim of this study was to evaluate the placebo effects of antidiabetic therapies in Asian and Caucasian T2DM patients and make a comparison between the two ethnicities.A search using the MEDLINE database, EMBASE, and Cochrane Database was performed, from when recording began until December 2016. The main concepts searched in English were sulfonylurea (SU); alpha glucosidase inhibitors (AGI); metformin (MET); thiazolidinediones (TZD); dipeptidyl peptidase-4 inhibitors (DPP-4i); sodium-glucose cotransporter 2 inhibitors (SGLT2i); glucagon-like peptide-1 receptor agonist (GLP-1RA); type 2 diabetes (T2DM); placebo controlled; and randomized controlled trials. Using the Cochrane instrument, we evaluated the adequacy of randomization, allocation concealment procedures, and blinding.This study included 63 studies with a total of 7096 Asian patients involved and 262 studies with a total of 27,477 Caucasian patients involved. In Caucasian population, the use of placebo led to significant reductions of glycosylated hemoglobin (HbA1c), -0.683% (P = 0.008) in SU monotherapy treatment, -0.193% (P = 0.001) in DPP-4i treatment, and -0.230% (P < 0.001) in SGLT2i treatment, respectively. In Asian population, the use of placebo resulted in significant decreases of HbA1c, -0.162% (P = 0.012) in DPP-4i treatment and -0.269% (P = 0.028) in GLP-1RA add-on therapy, respectively. The placebo also significantly reduced body weight. In Caucasian population, placebo use resulted in 0.833 kg (P = 0.006) weight loss by SU treatment and 0.953 kg (P = 0.006) weight loss by GLP-1RA treatment. In Asian population, the placebo led to a weight change of 0.612 kg (P < 0.001) by GLP-1RA analog treatment. The changes of HbA1c and weight due to the placebo effect in other treatments were not significant in both Asian and Caucasian population. Comparisons of the placebo effect on HbA1c change and weight change in each treatment group indicated that no significant difference was found between Asian and Caucasian population.The overall differences of the placebo effect on HbA1c changes as well as on body weight changes were not significant between Asian and Caucasian T2DM patients. The placebo effect on HbA1c changes and weight changes was not associated with baseline age, gender, baseline body mass index, baseline HbA1c, duration of diabetes, or study duration.亚洲与欧美人群2型糖尿病患者的安慰剂效应比较摘要背景:安慰剂效应被理解为非特定心理及生理效应,而无特定药理学效应。有证据显示,在2型糖尿病治疗方面,安慰剂效应源自于减少总热量的摄入以及减轻体重。本荟萃分析的目的是系统评价在亚洲与欧美2型糖尿病患者人群中的安慰剂效应,并比较安慰剂效应在两人种之间的差异。 方法:在MEDLINE、EMBASE、Cochrane等数据库中进行文献检索,检索截止时间2016年11月。检索关键词为英文,包括:磺脲类(SU)、α-糖苷酶抑制剂(AGI)、二甲双胍(MET)、噻唑烷二酮类(TZD)、二肽基肽酶-4抑制剂(DPP-4i)、钠葡萄糖协同转运蛋白2抑制剂(SGLT2i)、胰高血糖素样肽受体激动剂(GLP-1RA)、2型糖尿病(T2DM)、空白对照、随机对照试验。应用Cochrane协作网对临床随机分组、对照、双盲研究进行质量评估。 结果:本荟萃分析共纳入63项亚洲人群研究(7096名患者)和262项欧美人群研究(27477名患者)。在欧美人群中,安慰剂的使用带来了糖化血红蛋白(HbA1c)的显著下降,其中SU单药治疗组-0.683% (P=0.008)、DPP-4i组-0.193% (P=0.001)及SGLT2i组-0.230%(P=0.000)。在亚洲人群中,安慰剂的使用在DPP-4i组及GLP-1RA联合治疗组也带来了HbA1c的显著下降,分别为-0.162% (P=0.012)、-0.269% (P=0.028)。安慰剂效应同时带来了显著的体重减轻,在欧美人群中,安慰剂所致的体重下降在SU组为-0.833kg (P=0.006)、GLP-1RA组为-0.953kg (P=0.006)。在亚洲人群中,安慰剂所致的体重下降在GLP-1RA组为-0.612kg (P=0.000)。安慰剂效应对HbA1c变化及体重变化的影响在两个人群中的其它治疗组均无显著变化。各治疗组间的比较显示,安慰剂所致的HbA1c及体重变化在亚洲与欧美2型糖尿病人群中无明显差异。 结论:安慰剂效应对HbA1c变化及体重变化的影响在亚洲与欧美2型糖尿病人群中无显著差异,且与年龄、性别、基线体重指数(BMI)、基线HbA1c、糖尿病病程及研究时长无明显相关性。." @default.
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- W2810366714 date "2018-07-05" @default.
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- W2810366714 title "Comparison of Placebo Effect between Asian and Caucasian Type 2 Diabetic Patients" @default.
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