Selection criteria and identification of studies
The following criteria were adopted: (1) clinical randomized control trials (RCTs) aiming to study using glucokinase activator for treatment of T2DM;(2) Participants were adults (aged ≥18 years) at any risk of diabetes, including healthy adults and those with diagnosed diabetes;(3) BMI between 19·0 kg·m-2 and 35·0 kg·m-2;(4) There were no other treatment factors except metformin in the combined treatment group and the control group.
We excluded the following articles: (1) Patients enrolled by a clinical diagnosis of type 1 diabetes; a severe cardiovascular event within 6 months before the study; any type of malignancy; uncontrolled high blood pressure;(2) The data was incomplete or report repeatedly; (3) Articles not comparing the GKAs to placebo in T2DM;
Study inclusion, data extraction, and assessment of the risk of bias were conducted independently in duplicate. We assessed the Cochrane risk of bias tool domains13, as well as assessing risk from compliance problems and attention bias, specific to our set of reviews. We considered trials to be at low summary risk of bias if we judged randomization, allocation concealment, and blinding of participants, personnel, and outcome assessors to be adequate, whereas, on the contrary, we consider it to be at medium or high risk of bias.