Endocrine Abstracts

JOINT30

Background: This study evaluates the effectiveness of semaglutide and dapagliflozin alongside metformin, comparing it to vildagliptin and glimepiride alongside metformin in achieving diabetes remission.

Methods: An open-label, parallel, randomized controlled trial involving 85 participants diagnosed with T2DM within the past two years was conducted. The trial arm received semaglutide, dapagliflozin, and metformin, while the control arm received vildagliptin, glimepiride, and metformin. After 24 weeks, all medications were withdrawn to assess remission and relapse rates. The primary outcome was the proportion of patients achieving remission (HbA1c < 6. 5% without medication) and the time to relapse after stopping therapy.

Results: At the end of the 12 weeks after the completion of therapy, 26 (93%) and 11 (39%) patients were in remission in the trial and control arm, respectively. When compared at the end of 24 weeks, 36 weeks, and 52 weeks of completion of therapy, the remission rate was 71. 42% (n-20), 67. 85% (n-19), and 43. 42 % (n-13) in the trial arm as compared to 25% (n-7), 21. 42% (n-6), 3. 57% (n-1) in the control arm. The mean time to relapse was 39 weeks in the trial arm, compared to 19. 75 weeks in the control arm (p < 0. 001). Additionally, the trial arm, as compared to the control arm, exhibited a difference in median weight reduction of 5. 96 kgs. Factors associated with a delayed relapse included a greater decrease in HbA1c from baseline, improved beta-cell function as assessed by HOMA-β and the disposition index, and a reduction in insulin resistance measured by HOMA-IR and a decrease in BMI.

Conclusion: The combination of semaglutide and dapagliflozin, used alongside metformin, effectively induces remission and promotes weight loss in patients with type 2 diabetes mellitus (T2DM). This treatment demonstrates significant potential as a transformative approach to diabetes management. Additionally, discontinuing medications for three months supports sustainable remission outcomes, with positive results maintained even one year after the therapy has ended.