The Outcomes of Dapagliflozin Use in Real-Life Clinical Settings in Endocrinology Clinics of Islamabad, Pakistan

Abstract

IntroductionDapagliflozin is a member of a novel class of drugs (sodium-glucose cotransporter-2 inhibitors) used to treat type 2 diabetes mellitus and licensed in Pakistan in 2017. This retrospective observational study evaluated the effects of dapagliflozin on glycated hemoglobin (HbA1c) concentrations in patients treated at endocrinology clinics in Islamabad, Pakistan. The secondary objectives included assessing the effects of dapagliflozin on weight reduction and blood pressure control and to determining its safety. MethodologyPatients with type 2 diabetes who were treated with dapagliflozin were identified by screening the electronic medical records at tertiary care hospitals in Islamabad. Data were collected at the first visit and at follow-up. Categorical variables were recorded as frequencies and percentages and compared by McNemar's tests, and continuous variables were recorded as means and standard deviations and compared by paired sample ttests. ResultsMean HbA1C concentration was significantly lower at follow-up than at the first visit (7.57%±0.98% vs. 9.07%±2.07%, respectively; p<0.001). Bodyweight (85.09±15.92 kg vs. 87.07±16.11 kg, respectively; p<0.001) and diastolic blood pressure (80.34±7.12 mmHg vs. 82.34±9.61 mmHg, respectively; p<0.001) were also significantly lower at follow-up than at the first visit, whereas systolic pressure showed a marginally significant reduction (123.5±16.57 mmHg vs. 126.83±19.97 mmHg, p=0.048). ConclusionThis first observational study of patients in Pakistan treated with dapagliflozin found that HbA1c concentration, weight, and blood pressure were reduced after initiation of dapagliflozin treatment.

SGLT 2 Inhibitors; glycemic control, weight loss and safety profile in patients with type 2 Diabetes, at Medicell Institute (MIDEM)

“… 23 A recent publication on use of Dapagliflozin in Pakistan, reported mean HbA1c and weight reduction of -1.1% and -1.98 kg, respectively. 24 Our study results are comparable to above studies with mean HbA1c reduction of 1.34% and mean weight reduction of 2.3 kg.…”

Randomized Clinical Trial on Efficacy of Empagliflozin Versus Sitagliptin, In Addition to Metformin in Type 2 Diabetic Patients

“…Male predominance was seen in our study with male to female ratio of 4.47 comparable to other studies within Pakistan [ 16 , 17 ]. However, there are studies that report female predominance [ 18 , 19 ].…”

Clinical outcomes of Sodium-glucose cotransporter-2 inhibitors in patients with Type 2 Diabetes Mellitus: An observational study from Pakistan

“…Reduction in the HbA1c observed in this study, from 8.7 ± 1.5% to 7.9 ± 1.2% at 3 months and further reduction to 7.5 ± 1.1 at 6 months is comparable to the results of other real world studies and trials in which agents of this group were either used in combination or as monotherapy and showed improvement in HbA1c up to 1.8%. [13][14][15][16][17][18] This reduction in HbA1c and improvement in insulin sensitivity and decrease in insulin resistance along with a reduction in the beta-cell loss as reported by Merocvi A, et al 19 make SGLT2i as a potent agent to be used in combination or as monotherapy as supported by EASD-ADA position statement for DM management. 20 Most patients with T2DM are obese or overweight and weight loss in a diabetic patient is among the desired outcome because of its impact on insulin sensitivity, overall glycemic control, and long-term morbidities.…”

“…There is limited published data on the efficacy and safety of both agents of this novel anti-diabetic group, empagliflozin and dapagliflozin, among the Pakistani population. 14 , 15 Hence, we aimed this study to know about the efficacy of SGLT2i in terms of glycemic control and to report its effects on other metabolic parameters like reduction in the Body Mass Index (BMI) and change in the serum creatinine level along with adverse effects on Pakistani population in real-world practice.…”