Clinical Use of SGLT-2 Inhibitors for the Management of Type 2 Diabetes in a Patient Centered Medical Home

Abstract

1. Abstract 1.1.Purpose:To provide current data regarding the efficacy and tolerability of sodium-glucose cotransporter-2 (SGLT-2) inhibitors in type 2 diabetes mellitus (T2DM) patients at a large patient-centered medical home (PCMH) Multi-Specialty Physicians’ Group. 1.2.Methods: A retrospective observational study that took place at a PCMH located in Buffalo, NY. Eighty-one adults aged 18-95 years old with T2DM on a SGLT-2 inhibitor (canagliflozin, dapagliflozin, or empaglifozin) for a minimum of 3 months. Change in hemoglobin A1c (HbA1c) in addition to the percentage of patients achieving a HbA1c level below 7%. Changes in weight, changes in systolic (SBP) and diastolic (DBP) blood pressures, percentage of patients reporting adverse effects of therapy, and percentage of patients with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73%. 1.3.Results:81 patients met inclusion criteria. Mean HbA1c was significantly reduced by 1.04% after 3 months of therapy with 25.9% more patients achieving target HbA1c below 7%. A significant reduction was also observed in weight by an average of 7.33 pounds and in both SBP by 10 mmHg and DBP by 4 mmHg. Adverse effects were reported in 14.8% of patients with only 3 out of the 10 patients discontinuing therapy due to intolerance to side effects. 18.5% of patients had a decline in eGFR less than 60 mL/min/1.73%. Conclusion:SGLT-2 inhibitors exhibited tolerability and efficacy in T2DM patients who need to treat multiple aspects of their disease. This class of diabetic agents has the capability of maintaining control of hyperglycemia as well as blood pressure and weight, with minimal incidence of side effects.