Shusuke Yagi1,2,3, Ken-Ichi Aihara4, Takeshi Kondo5, Kiyoe Kurahashi5, Sumiko Yoshida5, Itsuro Endo5, Daiju Fukuda6, Yutaka Nakaya7, Kin-Ichiro Suwaki7, Takashi Takeji7, Toshihiro Wada7, Hotimah Masdan Salim8, Saori Hama8, Tomomi Matsuura8, Takayuki Ise8, Kenya Kusunose8, Koji Yamaguchi8, Takeshi Tobiume8, Hirotsugu Yamada8, Takeshi Soeki8, Tetsuzo Wakatsuki8, Munehide Matsuhisa9, Michio Shimabukuro6,10, Masashi Akaike11, Masataka Sata8. 1. Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan. syagi@tokushima-u.ac.jp. 2. Department of Community Medicine and Human Resource Development, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan. syagi@tokushima-u.ac.jp. 3. Department of Internal Medicine, Shikoku Central Hospital, Shikokuchuo, Ehime, Japan. syagi@tokushima-u.ac.jp. 4. Department of Community Medicine for Diabetes and Metabolic Disorders, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan. 5. Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan. 6. Department of Cardio-Diabetes Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan. 7. Department of Internal Medicine, Shikoku Central Hospital, Shikokuchuo, Ehime, Japan. 8. Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan. 9. Diabetes Therapeutics and Research Center, Institute of Advanced Medical Sciences, Tokushima University, Tokushima, Japan. 10. Department of Diabetes, Endocrinology and Metabolism, School of Medicine, Fukushima Medical University, Fukushima, Japan. 11. Department of Medical Education, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
Abstract
INTRODUCTION: Predictors for the effect of sodium glucose co-transporter 2 (SGLT2) inhibitors at lowering hemoglobin A1c (HbA1c) levels in type 2 diabetes mellitus patients remain unclear. We therefore aimed to elucidate these predictors in type 2 diabetes patients after 3 months of SGLT2 treatment. METHODS: A total of 302 consecutive type 2 diabetes patients who had been treated with SGLT2 inhibitors as monotherapy or add-on therapy to existing antidiabetic treatments were enrolled retrospectively. After excluding 27 patients whose HbA1c levels could not be evaluated 3 months after treatment, the glucose-lowering effects of SGLT2 inhibitors were assessed in 275 patients by measuring HbA1c levels before and 3 months after treatment. The predictors for changes in HbA1c levels after 3 months of treatment were evaluated. RESULTS: SGLT2 inhibitor treatment for 3 months decreased HbA1c levels from 7.8 ± 1.2% to 7.4 ± 1.0% (p < 0.0001). A multiple regression analysis showed that the independent determinants for SGLT2 inhibitor treatment effect included decreased HbA1c levels after 1 month of treatment, high baseline HbA1c levels, and a high estimated glomerular filtration rate (eGFR). CONCLUSION: We show that type 2 diabetes patients who received the greatest glucose-lowering effect with SGLT2 inhibitor treatment were those with preserved renal function (high baseline eGFR) and high baseline HbA1c levels. Moreover, SGLT2 inhibitor treatment efficacy could be predicted by the patients' initial response to treatment.
INTRODUCTION: Predictors for the effect of sodium glucose co-transporter 2 (SGLT2) inhibitors at lowering hemoglobin A1c (HbA1c) levels in type 2 diabetes mellituspatients remain unclear. We therefore aimed to elucidate these predictors in type 2 diabetespatients after 3 months of SGLT2 treatment. METHODS: A total of 302 consecutive type 2 diabetespatients who had been treated with SGLT2 inhibitors as monotherapy or add-on therapy to existing antidiabetic treatments were enrolled retrospectively. After excluding 27 patients whose HbA1c levels could not be evaluated 3 months after treatment, the glucose-lowering effects of SGLT2 inhibitors were assessed in 275 patients by measuring HbA1c levels before and 3 months after treatment. The predictors for changes in HbA1c levels after 3 months of treatment were evaluated. RESULTS:SGLT2 inhibitor treatment for 3 months decreased HbA1c levels from 7.8 ± 1.2% to 7.4 ± 1.0% (p < 0.0001). A multiple regression analysis showed that the independent determinants for SGLT2 inhibitor treatment effect included decreased HbA1c levels after 1 month of treatment, high baseline HbA1c levels, and a high estimated glomerular filtration rate (eGFR). CONCLUSION: We show that type 2 diabetespatients who received the greatest glucose-lowering effect with SGLT2 inhibitor treatment were those with preserved renal function (high baseline eGFR) and high baseline HbA1c levels. Moreover, SGLT2 inhibitor treatment efficacy could be predicted by the patients' initial response to treatment.
Authors: Moshe Phillip; Chantal Mathieu; Marcus Lind; Eiichi Araki; Paolo di Bartolo; Richard Bergenstal; Simon Heller; Lars Hansen; Markus Florian Scheerer; Fredrik Thoren; Niki Arya; John Xu; Nayyar Iqbal; Paresh Dandona Journal: Diabetes Obes Metab Date: 2020-11-24 Impact factor: 6.577