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The effect and safety of diacerein in patients with type 2 diabetes mellitus : a systematic review and meta-analysis.

Abstract
The Background: Diacerein has been proposed as a treatment option for management of type 2 diabetes due to its anti-inflammatory properties.
PURPOSE:
The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) is to examine the effect and safety of diacerein in patients with type 2 diabetes.
DATA SOURCES AND STUDY SELECTION:
We searched Pubmed, Embase, and Cochrane Library for RCTs published from database inception to September 2017.
DATA EXTRACTION AND DATA SYNTHESIS:
Among 44 studies that were initially identified, four were eligible and were included in the following analysis. Diacerein significantly reduced fasting glycemia [weighted mean differences (WMD) -0.66, 95% confidence interval (95% CI) -1.16 to -0.16] and glycated hemoglobin A1c (HbA1c ) (WMD -0.85, 95% CI -1.44 to -0.26). And the patients with a diacerein supplementation duration of ≤12 weeks had a greater decrease of fasting glycemia and HbA1c than the supplementation duration of >12 weeks. Furthermore, compared with placebo, diacerein revealed a significant increase in the relative risk (RR) of gastrointestinal symptoms (RR=2.50, 95% CI: 1.10 to 5.65), especially in the study subgroup with supplementation duration of >12 weeks (RR=4.01, 95% CI: 2.32 to 6.95).
LIMITATIONS:
The sample size was relatively small and the duration of included studies was short so that the treatment efficacy and safety for longer duration was unknown.
CONCLUSIONS:
Although further studies are needed, our findings clearly provide support to the use of diacerein in the clinical management of subjects with type 2 diabetes.
AuthorsQi Zhang, Junteng Zhou, Yushu Wang, Decai Chen
JournalAmerican journal of clinical and experimental immunology (Am J Clin Exp Immunol) Vol. 6 Issue 6 Pg. 97-106 ( 2017) ISSN: 2164-7712 [Print] United States
PMID29348985 (Publication Type: Journal Article)

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