Background: Few systematic reviews have examined the effects of sodium-glucose co-transporter 2 inhibitors (SGLT2is) on lipid profiles in Asian patients with type 2 diabetes mellitus. We conducted a systematic review with a meta-analysis to summarize the available literature and confirm the effects of SGLT2is on lipid profiles in these patients. Methods: We searched the electronic databases MEDLINE, CENTRAL, and Ichushi-web for studies from the dates of their earliest publication to July 2018, and there was no language restriction. Trials were included if they were randomized controlled trials (RCTs) (1) comparing the effects of SGLT2is with a placebo in Asian patients with type 2 diabetes mellitus (18 years or older), and (2) reporting HbA1c and at least one lipid parameter, such as triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), or low-density lipoprotein cholesterol (LDL-C). The weighted mean difference with a 95% confidence interval (CI) was calculated using a random-effects model. Results: Among the 630 studies retrieved, 17 RCTs that included 4485 patients were ultimately included in our review. Fourteen RCTs were conducted in Japan. The durations of RCTs ranged between 12 and 24 weeks. SGLT2is significantly improved HbA1c [mean difference − 0.80 (95%CI − 0.96 to − 0.64)%, p < 0.00001], TG [mean difference − 16.42 (95%CI − 22.71 to − 10.12) mg/dL, p < 0.00001], and HDL-C [mean difference 3.36 (95%CI 2.73 to 3.98) mg/dL, p < 0.00001], but significantly deteriorated LDL-C [mean difference 3.00 (95%CI 1.18 to 4.82) mg/dL, p < 0.001]. The LDL-C/HDL-C ratio was not significantly different between SGLT2is and a placebo [mean difference − 0.01 (95%CI − 0.08 to 0.06), p < 0.74].

The safety profiles of sodium-glucose co-transporter 2 (SGLT2) inhibitors may depend on races/ethnicities. We aimed to assess the safety profiles of SGLT2 inhibitors in Japanese patients with diabetes mellitus (DM). The electronic databases MEDLINE, CENTRAL, and Ichushi-web were searched for studies with no language restriction from their inception to August 2019. Trials were included in the analysis if they were randomized controlled trials (RCTs) comparing the effects of SGLT2 inhibitors with a placebo in Japanese patients with DM > 18 years and reporting HbA1c and at least 1 adverse event. We calculated risk ratios with 95% CIs and used a random-effects model. Of the 22 RCTs included in our review, only 1 included patients with type 1 DM. The durations of RCTs ranged between 4 and 24 weeks. In comparison with a placebo, SGLT2 inhibitors were associated with similar risks of hypoglycemia, urinary tract infection, genital infection, hypovolemia, and fracture. The outcomes of treatment with SGLT2 inhibitors among Japanese patients with DM suggest favorable safety profiles. However, further evidence from studies with a longer duration, involving more diverse populations, such as patients with different types of DM, or including individual SGLT2 inhibitors is needed to resolve the limitations of the present study.

BackgroundRandomized controlled trials (RCTs) reported that resistant dextrin (RD) exerted pleiotropic effects on humans. However, limited information is available on the effects of RD for weight loss. We conducted a systematic review with a meta-analysis to summarize the available literature and compare the efficacy of RD for weight loss with that of a placebo in overweight adults.MethodsWe searched the electronic databases MEDLINE, EMBASE, The Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, Web of Science, ClincalTrials.gov, and Japana Centra Revuo Medicina (Ichushi-web) for studies from their onset to November 2016, and there was no language restriction. Trials were included if they were RCTs (1) comparing the effects of RD with a placebo in adults (18 years or older), (2) reporting body mass index, and (3) including overweight/obese subjects as defined by the authors of RCTs. The weighted mean difference with a 95% confidence interval (CI) was calculated using a random-effects model.ResultsOf the 484 studies retrieved, 3 RCTs involving 275 subjects were included in our review. The durations of RCTs ranged between 8 and 12 weeks. All RCTs were conducted in Asian countries. RD significantly improved body mass index [mean difference −0.39 (95% CI −0.57 to −0.21) kg/m2, p < 0.01] and body weight [mean difference −0.81 (95% CI −0.93 to −0.69) kg, p < 0.01] in overweight adults.ConclusionOur review suggests that RD exerts beneficial effects for weight loss in overweight adults. More RCTs with different populations and longer follow-ups are needed in order to confirm that supplementation with RD has beneficial effects for weight loss in overweight adults. We consider this review to provide important information for the future submission of food with health claims.

The secondary and adverse eŠects when biguanides, alpha-glycosidase inhibitor or thiazolidine derivative was used with sulphonylurea agent (SU) as compared with those with SU alone in Type 2 diabetes patients by using Systematic Review. Two-agent concurrent treatment groups, taken from studies in which subjects were assigned to a group given only a sulfonylurea agent and a group given a sulfonylurea agent with the other glycemic control agent (combination of a sulfonylurea agent and a biguanide agent (I), combination of a sulfonylurea agent and an a-glucosidase inhibitor (II), and combination of a sulfonylurea agent and thiazolidinedione (III)), were studied in a randomized controlled trial. The secondary e‹cacy outcome measures were total cholesterol (TC), triglyceride (TG), HDL-C, LDL-C, and change in body weight. The incidence of hypoglycemia, feeling of fullness, diarrhea, liver dysfunction, and edema was investigated as a safety outcome measure, and the clinical signiˆcance of concurrent treatment with a sulfonylurea agent in addition to the other glycemic control agent was investigated. With respect to (II), an antidiabetic eŠect was showed. As for (III), it had the disadvantage of increased body weight. Furthermore, increase of HDL-C levels, in particular, was observed. The improving eŠect of (III) on serum lipids may be clinically eŠective for considering the pathologic condition of diabetes, which is often complicated by hyperlipidemia.

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We conducted a literature review and meta-analysis of safety profiles of sodium-glucose co-transporter 2 (SGLT2) inhibitors in Japanese patients with diabetes mellitus (DM). The electronic databases MEDLINE, CENTRAL, and Ichushi-web were searched for studies from their inception through to August 2019 and there was no language restriction. Trials were included in the analysis if they were randomized controlled trials (RCTs) (1) comparing the effects of SGLT2 inhibitors with a placebo in Japanese patients with DM ≤ 18 years, and (2) reporting HbA1c and at least one adverse event. We calculated risk ratios with 95%CI and used a random-effects model. Twenty-two out of the 765 RCTs retrieved were ultimately included in the present review, and only one RCT included patients with type 1 DM. The durations of RCTs ranged between 4 and 24 weeks. In comparisons with a placebo, SGLT2 inhibitors were associated with similar risks of hypoglycemia, urinary tract infection, genital infection, hypovolemia, and fracture. The outcomes of treatments with SGLT2 inhibitors among Japanese patients with DM suggest favorable safety profiles. However, further evidence from studies with a longer duration, involving more diverse populations, or including individual SGLT2 inhibitors is needed to resolve the limitations of the present study.

This study aimed to evaluate the usefulness of the practicum as well as assess the knowledge, skills, and various specific realizations that the students gained from it. A total of 244 students role-played a scenario in which a pharmacist visited a patient at home and provided pharmaceutical management services. After completing the practicum, the students completed (i) a questionnaire survey consisting of six questions that assessed their level of understanding of the role of pharmacists in home medical care and (ii) a rubric survey that evaluated their learning achievement. In addition, they submitted practicum portfolios describing the patients’ living conditions, physical conditions, and background as well as the services that required consideration of said variables. Their responses to the portfolio item “What were noticed through the practicum” were analyzed using the grounded theory approach. After the practicum, 45% and 53% of the students reported having a full and partial understanding of a pharmacists’ role in home medical care. The students’ mean ± standard deviation rubric score was 3.0 ± 0.4. They classified monitoring drug use, support for improving medication adherence, and observation to identify side effects early as major service categories in home medical care. The practicum led the students to perceive the need for communication with patients and various healthcare professionals to improve their readiness for practical training.

We performed a meta-analysis to assess antihypertensive eŠect, lipid metabolism, insulin resistance index, and body weight changes in patients with borderline diabetes and diabetes treated with angiotensin II receptor blockers (ARB) and dihydropyridine calcium channel blockers (CCB). Literatures for analysis were searched in MEDLINE, the Cochrane Library, and Japana Centra Revuo Medicina. Reports on randomized controlled trials in which the therapeutic results in borderline and diabetic patients were compared between those treated with ARB and CCB were retrieved, and 16 reports met the objective of this study. The e‹cacy in the two drug treatment groups were divided into 8 outcomes and evaluated. The e‹cacy outcomes on handling continuous data were integrated using the weighted mean diŠerence, in which the random-eŠects model was selected for the statistical model. The statistical heterogeneity of each outcome was also tested. The systolic and diastolic blood pressures were signiˆcantly reduced in the CCB compared to the ARB treatment group. No signiˆcant diŠerences were noted between the two groups in the triglyceride or low-density lipoprotein cholesterol level or body weight changes. It was shown that the CCB was more eŠective than ARB for the improvement of systolic and diastolic blood pressures in patients with borderline diabetes and diabetes, while no signiˆcant diŠerences were noted in the e‹cacy other than the antihypertensive eŠect between ARB and CCB treatment groups. This study would provide information in selecting antihypertensive agents for borderline and diabetic patients.