Comparisons of the Efficacy of Alpha Glucosidase Inhibitors on Type 2 Diabetes Patients between Asian and Caucasian

BACKGROUND To compare the efficacy of glycemic control and insulin secretion of alpha glucosidase inhibitors (AGI) on type 2 diabetes patients between Asian and Caucasian. METHODOLOGY/PRINCIPAL FINDINGS The MEDLINE®, EMBASE®, CENTRAL were searched and qualified studies in Asian and Caucasian population comparing AGI treatment with placebo or other oral anti-diabetic drugs in type 2 diabetic patients were included. Totally 58 qualified studies were included. When AGI treatment was compared with placebo, a significant difference in HbA1c decline from baseline favoring AGI treatment was found in Asian (weighted mean difference (WMD), -0.50%; 95% CI, -0.66% to -0.34%) and in Caucasian a significant difference in HbA1c decline favoring AGI treatment was also found (WMD, -0.68%; 95% CI, -0.76% to -0.60%). In Asian, fasting plasma glucose was reduced with AGI treatment compared with placebo (WMD, -0.53 mmol/L; 95% CI, -0.91 to -0.14 mmol/L) and in Caucasian there was also a significant difference in FPG changes favoring AGI therapy (WMD, -0.88 mmol/L; 95% CI, -1.00 to -0.77 mmol/L). Studies in Asian showed a significant difference in fasting insulin changes favoring AGI treatment (WMD, -0.78 uU/ml; 95% CI, -0.96 to -0.59 uU/ml). While in Caucasian fasting insulin was decreased without significance with AGI treatment (WMD-1.24 uU/ml; 95% CI, -2.51 to 0.04 uU/ml). Body weight was decreased with AGI treatment in Asian (WMD, -1.00 kg; 95% CI, -1.69 to -0.31 kg) and was also decreased with AGI treatment in Caucasian (WMD, -0.73 kg; 95% CI, -1.13 to -0.33 kg). CONCLUSIONS/SIGNIFICANCE According to results from this meta-analysis, the efficacy in glucose lowering, body weight reduction and insulin secretion decreasing of AGI treatment in Asian were comparable with those in Caucasian.