Abstract
The aim of this study was to investigate the effectiveness of SGLT2 inhibitors with regard to metabolic parameters and patient safety under routine ambulatory conditions. Retrospective longitudinal study of 95 patients with type 2 diabetes (diabetes duration 13.3 y; HbA1c 8.9%; eGFR 80.1 mL/min) receiving SGLT-2-inhibitors. Metabolic control and adverse event profile were evaluated. The mean follow-up time was 1.2 ± 0.8 years. The following changes were observed: HbA1c −1.0% ± 1.9 (p < 0.001), eGFR −7.0 mL/min ± 13.3 (p < 0.001), albuminuria −23.9 mg/g creatinine ± 144.5 (p = 0.118), bodyweight −3.0 kg ± 5.8 (p < 0.001), systolic blood pressure −6 mmHg ± 22 (p = 0.01), diastolic blood pressure −2 mmHg ± 14 (p = 0.243). 53 participants continuously applied the therapy. Twenty-eight participants discontinued SGLT-2-inhibitors due to various reasons: 20 participants because of genital- or urinary tract infections. One for dysuria, seven due to reduced eGFR below 45 mL/min. This study showed a considerable reduction of HbA1c and a modest reduction of eGFR, bodyweight and systolic blood pressure under clinical routine conditions. Genital infections occurred markedly more often than in randomized controlled trials. To apply SGLT-2-inhibitors more safely in clinical routine individual risks for genital and urinary tract infections should be considered and re-evaluated during therapy.
Highlights
There are numerous placebo-controlled studies that have investigated the effect of sodium-glucose cotransporter-2 inhibitors (SGLT2 inhibitors) in people with type 2 diabetes (EMPAREG, CANVAS, CREDENCE, DECLARE) [1]
Our findings showed that SGLT-2-inhibitors were effective as an addon therapy of diabetes mellitus type 2 treatment
This study showed that SGLT-2-inhibitors were effective as an add-on therapy in clinical routine of diabetes care
Summary
There are numerous placebo-controlled studies that have investigated the effect of sodium-glucose cotransporter-2 inhibitors (SGLT2 inhibitors) in people with type 2 diabetes (EMPAREG, CANVAS, CREDENCE, DECLARE) [1] The aim of these studies was to investigate the safety of SGLT2 inhibitors with respect to major adverse cardiovascular and renal outcomes. After initial lowering of the estimated glomerular filtration rate (eGFR) because of reducing hyperfiltration, long-term renal function is preserved better and reduces less with SGLT2 inhibitor treatment [4] Based on these placebo-controlled studies, some guidelines recommend the use of SGLT2 inhibitors as first-line or second-line therapy after metformin in patients with cardiovascular disease, diabetic nephropathy, heart failure or corresponding risks [5]. This study was undertaken to provide data from routine care on the effectiveness regarding metabolic parameters and blood pressures, and the frequency of adverse effects
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