Colesevelam for Type 2 diabetes mellitus: an abridged Cochrane review

Authors

  • C. P. Ooi,

    Corresponding author
    1. Endocrine Unit, Department of Medicine, Faculty of Medicine and Health Sciences, Serdang, Malaysia
    2. Institute of Gerontology, Universiti Putra Malaysia, Serdang, Malaysia
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  • S. C. Loke

    1. Endocrine Unit, Department of Medicine, Faculty of Medicine and Health Sciences, Serdang, Malaysia
    2. Institute of Gerontology, Universiti Putra Malaysia, Serdang, Malaysia
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Errata

This article is corrected by:

  1. Errata: Erratum Volume 31, Issue 2, 249, Article first published online: 20 January 2014

  • This review is an abridged version of a Cochrane Review previously published in the Cochrane Database of Systematic Reviews, DOI: 10.1002/14651858.CD00 (see www.thecochranelibrary.com for information). Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback, and Cochrane Database of Systematic Reviews should be consulted for the most recent version of the review.

Abstract

Aim

Colesevelam, a second-generation bile acid sequestrant, may be beneficial in controlling both glycaemia and lipids simultaneously. Our goal was to evaluate the systemic effects of colesevelam on Type 2 diabetes mellitus.

Method

The original Cochrane review was conducted using the methodology for the systematic review of interventions of the Cochrane Collaboration in RevMan 5.2. We comprehensively searched the literature in several databases up to January 2012. Two reviewing authors independently selected and extracted the data, and then evaluated the quality of the randomized controlled trials that met the inclusion criteria.

Results

Six randomized controlled trials were selected, which ranged from 8 to 26 weeks in duration. A total of 1450 participants were divided into two groups: those treated with colesevelam and no other anti-diabetic drug treatments/placebo, or with colesevelam added on to anti-diabetic drug treatments. The colesevelam added on to anti-diabetic agents demonstrated a statistically significant reduction in the fasting blood glucose (mean difference of –0.82 mmol/l, 95% CI –1.2 to –0.44), HbA1c (mean difference –0.5%, 95% CI –0.6 to –0.4) and LDL cholesterol (mean difference –0.34 mmol/l, 95% CI –0.44 to –0.23). There were no reported data on weight. Non-severe hypoglycaemic episodes were infrequently observed.

Conclusion

The limited number of studies concerning the treatment with colesevelam added to anti-diabetic agents showed significant effects on glycaemic control; however, more research on the reduction of cardiovascular risks is required. Furthermore, long-term data on the health-related quality of life and all-cause mortality also need to be investigated.

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