Endocrine Abstracts

Objective: SGLT2 inhibitors, have been shown to improve glycaemic control, stabilize insulin dosing and mitigate insulin-associated weight gain in patients whose type 2 diabetes mellitus (T2DM) was inadequately controlled. The objective is to evaluate the real-world efficacy and safety of adding iSGLT-2 therapy in inadequately controlled patients with oral antidiabetic drugs and with or without insulin therapy.

Materials and methods: This observational study assessed the efficacy and safety of SGLT-2 inhibitors used as add-on therapy in a group of 45 T2DM patients from a community endocrinology practice from January 2015 to April 2016. Primary endpoint was HbA1c mean change from baseline at 15 months. Secondary endpoints included change in body weight,other glycaemic parameters,and percentage of patients reporting adverse effects of therapy.

Results: A total of 45 patients met all the study criteria. 60% with oral antidiabetic drugs, 11.1% with oral antidiabetic drugs and basal insulin regimens, 11.11% with basal-bolus insulin therapy and 17.8% with oral antidiabetic drugs and basal-bolus insulin therapy.Baseline patient characteristics were as follows: average age, 60.2±9.7 years; mean duration of T2DM, 11.3±8.3 years; 80% male; baseline body mass index (BMI), 32.76±4.96 kg/m²; mean baseline HbA1c, 9.17±2.02%;systolic BP 143.67±15.46 mmHg and diastolic BP 80.44±10.16 mmHg. Mean duration of SGLT2 inhibitors 7.42±4.22 months. HbA1c and weight were significantly reduced by 1.36±1.79%, P < 0.000 and 3.21±3.52 kg, P < 0.000, respectively; systolic BP (12.91±10.57 mmHg, P <0.000), diastolic BP (6.39±7.34 mmHg P< 0.000) and triglycerides (45.58±115.65 mg/dl, P < 0.011). Genital- and urinary tract infections were reported by 6.7% patients.Any diabetic ketoacidosis case was reported.

Conclusion: SGLT-2 Inhibitors added to other oral antidiabetic drugs or insulin in patients with uncontrolled T2DM significantly improved glycemic control, reduced weight, blood pressure and triglycerides,and was generally well tolerated.In conclusion, SGLT-2 inhibitors,appears to be an important addition to the therapeutic options for the management of type 2 diabetes, particularly when used as add-on therapy.