88-LB: The Microvascular Effects of the Noninsulin Standard Antidiabetic Medications—A Literature Systemic Review of Randomised Controlled Clinical Studies

Backgrounds: As many advances have been made in recent decades in the understanding of the pathophysiology of diabetic macrovascular complications and novel pharmacological approach, few investigations on the importance and how the hypoglycemic medications that are currently available in reducing diabetic microvascular complications, though this amelioration can be achieved via intensive glycemic control such as insulin therapy. This study reviews the implications of diabetic microvascular complications by non-insulin antidiabetic medications.

Methods: We searched and screened the literature of randomized clinical trials that reported the effects of drugs on diabetic microvascular complications, including diabetic nephropathy (DN), diabetic peripheral neuropathy (DPN), diabetic retinopathy (DR) from multiple clinical databases. We extracted the indices of estimated glomerular filtration rate (eGFR) and urinary albumin to creatinine ratio (UACR) or urinary albumin excretion rate (UAE), and indices for DPN or DR. Comparisons were made between certain classes of non-insulin antidiabetic medications.

Main Results: The analyses showed the urinary albumin to creatinine ratio (UACR) or urinary albumin excretion rate (UAE) showed variations in both the effects and significance of the decline. In addition, due to the unavailable of a unified standard metric index on DPN or DR, we compiled different common measures on the DPN or DR, and also found disparities in both the effect and significance of each medication.

Conclusions: Till now, all the reviewed non-insulin hypoglycemic medications showed different degrees of preventing diabetic microvascular complications. As emerging or ongoing trials will reveal the implications of diabetic microvascular prevention, more results with higher quality in comparative efficacy between different classes of non-insulin antidiabetic medications could serve as more powerful evidence for recommendation and utilized in clinical personalized treatment practices.