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Glucagon-Like Peptide-1 Receptor Agonist and Risk of Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis of Randomized Placebo-Controlled Trials

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Abstract

Background

Glucagon-like peptide 1 receptor agonists (GLP-1RAs) exhibit glucose-lowering, weight-reducing, and blood pressure-lowering effects. Nevertheless, a debate exists concerning the association between GLP-1RA treatment and the risk of diabetic retinopathy (DR) in patients diagnosed with type 2 diabetes mellitus (T2DM).

Objective

To ascertain the risk of DR in patients with T2DM undergoing GLP-1RA treatment, we conducted a meta-analysis utilizing data derived from randomized placebo-controlled studies (RCTs).

Methods

A comprehensive literature search was conducted using PubMed, Cochrane Library, Web of Science, and EMBASE. We focused on RCTs involving the use of GLP-1RAs in patients with T2DM. Utilizing R software, we compared the risk of DR among T2DM patients undergoing GLP-1RA treatment. The Cochrane risk of bias method was employed to assess the research quality.

Results

The meta-analysis incorporated data from 20 RCTs, encompassing a total of 24,832 T2DM patients. Across all included trials, randomization to GLP-1 RA treatment did not demonstrate an increased risk of DR (odds ratio = 1.17; 95% CI 0.98–1.39). Furthermore, no significant heterogeneity or publication bias was detected in the analysis.

Conclusion

The results of this systematic review and meta-analysis indicate that the administration of GLP-1 RA is not associated with an increased risk of DR.

Prospero Registration Identifier

CRD42023413199.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, No. 1, Minde Road, Donghu District, Nanchang, 330006, China

    Xiaojuan Jiao, Ping Peng, Qin Zhang & Yunfeng Shen

  2. Branch of National Clinical Research Center for Metabolic Diseases, Nanchang, 330006, China

    Xiaojuan Jiao, Ping Peng, Qin Zhang & Yunfeng Shen

  3. Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, China

    Xiaojuan Jiao, Ping Peng, Qin Zhang & Yunfeng Shen

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Xiaojuan Jiao and Ping Peng researched the data, contributed to the discussion, and wrote the manuscript. Qin Zhang researched the data. Yunfeng Shen contributed to the discussion, and reviewed and edited the manuscript.

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Jiao, X., Peng, P., Zhang, Q. et al. Glucagon-Like Peptide-1 Receptor Agonist and Risk of Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis of Randomized Placebo-Controlled Trials. Clin Drug Investig 43, 915–926 (2023). https://doi.org/10.1007/s40261-023-01319-x

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