Endocrine Abstracts

Before launching of SGL‐2 inhibitor, triple combination of TZD with metformin and DPP‐4 inhibitor was best option for delaying progression of diabetes by improving insulin resistance and secretory dysfunction. But due to side effects of TZD such as weight gain and edema, SGL‐2 inhibitor can be another option instead of TZD. So we tried to know the effect of SGLT2 inhibitor switching from TZD with triple combination therapy in type 2 diabetes. In 80 patients treated with triple combination of metformin, DPP4 inhibitor and 15 mg of pioglitazone –the usual dose in this country, pioglitazone was switched to 10 mg of dapaglifozin or empagloflozin. The 6 months after HbA1c was compared with mean HbA1c of 3 months and just before switching. Weight change was compared and other clinical characteristics were assessed. The mean age was 59.6±11.4, duration of diabetes was 9.3±4.3 year and BMI was 28.3±3.6. The HOMA-IR was 3.59±3.5 and fasting c-peptide was 2.42±1.16. The mean of HbA1c 3 month and just before switching was 6.90±0.58%. HbA1 was increased in 44%, decreased in 39% and mean elevation and reduction was 0.49 and 0.64, each in 52 patients with dapaglifozin group. HbA1 was increased in 46%, decreased in 46% and mean elevation and reduction was 0.33 and 0.48, each in 28 patients with empagloflozin group. HOMA-IR was improved by 3.79 in 62% and aggravated by 1.90 in 38%. Body weight was reduced in 100% by 4.92±2.38 kg. So, triple combination of SGLT-2 inhibitor with metformin and DPP‐4 inhibitor was similar effec in glucose control, but efficient in weight control compared to TZD as expected.