SynthesisFrontiers in endocrinology2022

Relationship Between SGLT-2i and Ocular Diseases in Patients With Type 2 Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials.

Bin Zhou, Yetan Shi, Rongrong Fu, Haixiang Ni, Lihu Gu, Yuexiu Si, Mengting Zhang, Ke Jiang, Jingyi Shen, Xiangyuan Li and 1 more

Open access · goldFull text readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Frontiers in endocrinology, 2022. The graph read 4 numbers from its abstract, feeding 3 cells of the map: it finds no clear difference in 2. Cited by 17 papers, 1 of them a synthesis that pooled it.

4numbers the graph read from it
3cells of the map it votes in
17citing papers in PubMed, 1 pooled it
4.6field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

← favours the comparatorfavours the treatment →
0.500 · no effect
Adverse events & safetyfavours the treatment · against placebo · t2dfeeds one cell of the map
RR 0.47P=0.01
Ertugliflozin (RR=0.47, P=0.01) reduced the risk for retinal disease, while empagliflozin (RR=0.44, P=0.05) reduced the risk for diabetic retinopathy (DR) compared with controls.
Hypoglycaemiano clear difference · against placebo · t2dfeeds 2 cells of the map
RR 0.47P=0.06
SGLT-2i (RR=0.50, P=0.02), perhaps empagliflozin (RR=0.47, P=0.06), reduced the risk of retinal disease compared with active hypoglycemic agents.
Hypoglycaemiafavours the treatment · against placebo · t2dfeeds 2 cells of the map
RR 0.50P=0.02
SGLT-2i (RR=0.50, P=0.02), perhaps empagliflozin (RR=0.47, P=0.06), reduced the risk of retinal disease compared with active hypoglycemic agents.
Adverse events & safetyno clear difference · against placebo · t2dfeeds one cell of the map
RR 0.44P=0.05
Ertugliflozin (RR=0.47, P=0.01) reduced the risk for retinal disease, while empagliflozin (RR=0.44, P=0.05) reduced the risk for diabetic retinopathy (DR) compared with controls.

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Other glucose-lowering×hypoglycaemia

No readable resultOpen on the map →What to test next →

1 readable study in this cell: 1 favour the treatment, 0 find no difference, 0 favour the comparator.

Belief with this paper
0.00contested · 0 families support, 1 contradict · head-to-head
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
NCT017093055,570 enrolled · 2012
Estimate -8.40-11.1 to -6.10

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

SGLT2 inhibitors×adverse events & safety

InconclusiveOpen on the map →What to test next →

38 readable studies in this cell: 18 favour the treatment, 19 find no difference, 1 favour the comparator.

Belief with this paper
0.00contested · 0 families support, 26 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
NCT011374742,996 enrolled · 2010
Δ -0.46-0.59 to -0.33
NCT017190031,413 enrolled · 2012
Adjusted mean -0.33-0.56 to -0.10
NCT020991101,233 enrolled · 2014
Δ 1.40-7.40 to 10.1
NCT018093271,186 enrolled · 2013
Δ -0.46-0.66 to -0.27
NCT01649297983 enrolled · 2012
Δ -0.61-0.79 to -0.44
NCT02580591977 enrolled · 2015
Δ -0.28-0.46 to -0.11
NCT02414958730 enrolled · 2015
Δ -0.54-0.66 to -0.41
NCT01381900678 enrolled · 2011
Δ -0.51-0.64 to -0.37
NCT02033889621 enrolled · 2013
Δ 1.50-2.10 to 5.40
NCT02532855614 enrolled · 2015
Δ -2.80-10.7 to 5.10
NCT02630706506 enrolled · 2015
Δ -6.00-16.5 to 4.60
NCT02036515464 enrolled · 2014
Δ -5.70-16.5 to 5.20

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

SGLT2 inhibitors×hypoglycaemia

InconclusiveOpen on the map →What to test next →

9 readable studies in this cell: 5 favour the treatment, 4 find no difference, 0 favour the comparator.

Belief with this paper
0.00contested · 0 families support, 2 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
1 · no effect
NCT0546531762,197 enrolled · 2022
HR 0.900.71 to 1.16
NCT009688121,452 enrolled · 2009
OR 0.100.06 to 0.16
NCT02580591977 enrolled · 2015
IRR 0.940.67 to 1.31
NCT02268214833 enrolled · 2014
OR 3.092.10 to 4.56
NCT02460978815 enrolled · 2015
OR 2.711.81 to 4.06
NCT02414958730 enrolled · 2015
IRR 0.740.52 to 1.07
NCT04233801219 enrolled · 2020
OR 1.760.68 to 4.55

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

17 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Review
  6. Article
  7. Article
  8. Article
  9. Review
  10. Article
  11. Article
  12. Review
  13. Article
  14. Observational
  15. Article
  16. Review
  17. Review
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Bin ZhouDepartment of General Surgery, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, China.
Yetan ShiThe Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.
Rongrong FuThe First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.
Haixiang NiThe Department of Endocrinology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
Lihu GuDepartment of General Surgery, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, China.
Yuexiu SiSchool of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China.
Mengting ZhangThe Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.
Ke JiangThe Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.
Jingyi ShenThe Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.
Xiangyuan LiThe Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.
Xing SunDepartment of General Surgery, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, China.
Zhejiang Chinese Medical University · CNUniversity of Chinese Academy of Sciences · CN

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

Background: This meta-analysis was conducted to explore the association between sodium-glucose cotransporter 2 inhibitors (SGLT-2is) and ocular diseases in type 2 diabetes mellitus (T2DM) patients. Methods: PubMed, Cochrane Central Registry of Controlled Trials, Web of Science and Springer were searched for articles on randomized controlled trials (RCTs) involving T2DM patients treated with SGLT-2i versus placebo or other hypoglycemic agents published prior to August 2021. The primary outcome of this meta-analysis was incidence of ocular diseases, which was assessed using risk ratios (RR) and 95% confidence intervals (CI). We reviewed 47 papers and compared the effect of SGLT-2i with the effect of the control groups (placebo and other hypoglycemic drugs) on the incidence of ocular diseases. Results: Compared with controls, overall SGLT-2i use in T2DM patients was not associated with incidences of cataract, glaucoma, retinal disease and vitreous disease. Ertugliflozin (RR=0.47, P=0.01) reduced the risk for retinal disease, while empagliflozin (RR=0.44, P=0.05) reduced the risk for diabetic retinopathy (DR) compared with controls. SGLT-2i (RR=0.50, P=0.02), perhaps empagliflozin (RR=0.47, P=0.06), reduced the risk of retinal disease compared with active hypoglycemic agents. Canagliflozin (RR=4.50, P=0.03) increased the risk for vitreous disease compared with placebo. Conclusions: There was no significant correlation between overall SGLT-2i and ocular diseases (cataract, glaucoma, retinal disease, vitreous disease, corneal disease, conjunctival disease, uveal disease, eye haemorrhage and vision problems) in T2DM patients. Ertugliflozin and empagliflozin may protect against ocular diseases, but canagliflozin may promote ocular diseases.

Indexed as

CataractDiabetes Mellitus, Type 2GlaucomaRetinal DiseasesSodium-Glucose Transporter 2 InhibitorsCanagliflozinHumansHypoglycemic AgentsRandomized Controlled Trials as TopicCanagliflozinHypoglycemic AgentsSodium-Glucose Transporter 2 Inhibitorsmeta-analysisocular diseasesRCTsSGLT-2iT2DM

Identifiers

PMID35692406
PMCPMC9178099
OpenAlexW4281567900

What Socratic holds

Textfull text, public
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.