1115-P: Comparative Rate of Amputations among Type 2 Diabetes Patients Starting Different SGLT2 Inhibitors

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1115-P
Author(s):  
STEPHANIE HAKIMIAN ◽  
AMISHA WALLIA ◽  
RAYMOND KANG ◽  
ANDREW J. COOPER ◽  
MATTHEW O’BRIEN ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Sglt2 Inhibitors ◽  
Comparative Rate ◽  
Diabetes Patients

scholarly journals Comparative risk evaluation for cardiovascular events associated with dapagliflozin vs. empagliflozin in real-world type 2 diabetes patients: a multi-institutional cohort study

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Shih-Chieh Shao ◽  
Kai-Cheng Chang ◽  
Ming-Jui Hung ◽  
Ning-I Yang ◽  
Yuk-Ying Chan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Cardiovascular Events ◽  
Cardiovascular Death ◽  
Sglt2 Inhibitors ◽  
Diabetes Patients

Abstract Background To compare the cardiovascular event risk in type 2 diabetes patients newly receiving dapagliflozin vs. empagliflozin. Methods We conducted a retrospective cohort study by analyzing a multi-institutional electronic medical records database (Chang Gung Research Database) in Taiwan and included adult type 2 diabetes patients who were newly receiving sodium–glucose co-transporter 2 (SGLT2) inhibitors from 2016 to 2017. The primary outcome was a composite of cardiovascular death, myocardial infarction, ischemic stroke and heart failure. We followed up patients from initiation of SGLT2 inhibitors until the occurrence of cardiovascular events before December 31, 2018. We performed multivariable Cox proportional hazard modeling, adjusting for patients’ age, sex, laboratory data, co-morbidities, and concomitant medications. Results We identified 12,681 new SGLT2 inhibitor users with a mean age of 58.9 (SD 11.8) years, of whom 43.9% were female and 45.8% were new dapagliflozin users. A total of 10,442 person-years of dapagliflozin use and 12,096 person-years of empagliflozin use were included. Compared to empagliflozin users, new users of dapagliflozin were found to have similar risks for primary composite outcome (adjusted HR: 0.91; 95% CI 0.73–1.14), cardiovascular death (adjusted HR: 0.54; 95% CI 0.14–2.12), myocardial infarction (adjusted HR: 0.77, 95% CI 0.49–1.19) and ischemic stroke (adjusted HR: 1.15; 95% CI 0.80–1.65), but a lower risk of heart failure (adjusted HR: 0.68; 95% CI 0.49–0.95). Conclusion The risk of cardiovascular events was similar between dapagliflozin and empagliflozin new users, but dapagliflozin may have a better outcome in the reduction of heart failure in type 2 diabetes patients. Future prospective studies are required to confirm the findings.

Clinical effectiveness study of SGLT2 inhibitors as added-on therapy for 149 insulin treated type 2 diabetes patients

2016 ◽  
Vol 120 ◽  
pp. S122-S123
Author(s):  
Yuan-Ching liu ◽  
Cheng-Wei Lin ◽  
I-Ying Chiu ◽  
Hsiao-Wei Lu ◽  
Cheng-Liang Chi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Effectiveness ◽  
Sglt2 Inhibitors ◽  
Effectiveness Study ◽  
Diabetes Patients

Abstract #307 Glycemic Outcomes of SGLT2 Inhibitors in Overweight or Obese Type 2 Diabetes Patients

2019 ◽  
Vol 25 ◽  
pp. 129-130
Author(s):  
Balaji Jaganmohan ◽  
S Venkataraman ◽  
Sambit Das ◽  
C.S. Dwarakanath ◽  
Sanjiv Shah ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Sglt2 Inhibitors ◽  
Glycemic Outcomes ◽  
Diabetes Patients

SGLT2 inhibitors’ interaction with other renoactive drugs in type 2 diabetes patients: still a lot to learn

2019 ◽  
Vol 96 (2) ◽  
pp. 283-286 ◽  
Author(s):  
Michaël J.B. van Baar ◽  
Rosalie A. Scholtes ◽  
Daniël H. van Raalte
Keyword(s):  
Type 2 Diabetes ◽  
Sglt2 Inhibitors ◽  
Diabetes Patients

scholarly journals Favorable pleiotropic effects of sodium glucose cotransporter 2 inhibitors: head-to-head comparisons with dipeptidyl peptidase-4 inhibitors in type 2 diabetes patients

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Shih-Chieh Shao ◽  
Kai-Cheng Chang ◽  
Swu-Jane Lin ◽  
Rong-Nan Chien ◽  
Ming-Jui Hung ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Sglt2 Inhibitor ◽  
Sglt2 Inhibitors ◽  
Pleiotropic Effects ◽  
Dipeptidyl Peptidase 4 ◽  
Dpp4 Inhibitors ◽  
Dpp4 Inhibitor ◽  
Diabetes Patients

Abstract Background Sodium glucose cotransporter 2 (SGLT2) inhibitors have shown greater reductions of cardiovascular event risks than dipeptidyl peptidase-4 (DPP4) inhibitors, whereby possible mechanisms may involve the better pleiotropic effects of SGLT2 inhibitors. However, no published data are currently available to directly compare glycemic and pleiotropic effects in real-world type 2 diabetes patients initiating SGLT2 inhibitors or DPP4 inhibitors. Method We conducted a retrospective cohort study by analyzing the Chang Gung Research Database, the largest multi-institutional electronic medical records database in Taiwan. We included patients newly receiving SGLT2 inhibitor or DPP4 inhibitor intensification therapy for type 2 diabetes from 2016 to 2017. We matched SGLT2 inhibitor users to DPP4 inhibitor users (1:4) by propensity scores to ensure comparable characteristics between the groups. We primarily evaluated 1-year post-treatment changes of hemoglobin A1c (HbA1c) after SGLT2 inhibitor or DPP4 inhibitor initiation, using two-tailed independent t-test. We also evaluated post-treatment changes in body weight, systolic blood pressure (SBP), alanine aminotransferase (ALT) and estimated glomerular filtration rate (eGFR) values, associated with SGLT2 inhibitors and DPP4 inhibitors. Results We identified a cohort of 2028 SGLT2 inhibitors and 8112 matched DPP4 inhibitors new users. SGLT2 inhibitors and DPP4 inhibitors showed similar HbA1c reductions (− 1.0 vs. − 1.1%; P = 0.076), but patients receiving SGLT2 inhibitors had greater improvements in body weight (− 1.5 vs. − 1.0 kg; P = 0.008), SBP (− 2.5 vs. − 0.7 mmHg; P < 0.001) and ALT values (− 4.1 vs. − 0.0 U/l; P < 0.001) and smaller declines in eGFR values (− 2.0 vs. − 3.5 ml/min/1.73 m2; P < 0.001) when compared to DPP4 inhibitors. Conclusion SGLT2 inhibitors had glucose-lowering effects comparable to those of DPP4 inhibitors but more favorable pleiotropic effects on body weight, ALT and eGFR changes, potentially improving type 2 diabetes patients’ cardio-metabolic disease risks.

scholarly journals Urinary A- and C-megalin predict progression of diabetic kidney disease: a retrospective cohort study

2021 ◽  
Author(s):  
Tomomichi Iida ◽  
Michihiro Hosojima ◽  
Hideyuki Kabasawa ◽  
Keiko Kabasawa ◽  
Sawako Goto ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Estimating Equation ◽  
Sglt2 Inhibitors ◽  
Diabetic Kidney ◽  
Novel Method ◽  
Egfr Slope ◽  
Diabetes Patients

Abstract Background Urinary excretion of megalin, a proximal tubular endocytic receptor, may be associated with the development and progression of diabetic kidney disease (DKD). However, no studies have assessed whether the levels of the urinary ectodomain (A-megalin) and full-length (C-megalin) forms of megalin can predict DKD progression. Methods We evaluated the correlation of urinary A-megalin levels of 34 patients with type 2 diabetes as measured by novel reducing and previous methods. Then, we retrospectively analyzed 188 type 2 diabetes patients not taking sodium glucose cotransporter 2 (SGLT2) inhibitors in order to investigate whether urinary A- and C-megalin might be used as predictors of kidney outcomes. The median observation period was 3.96 years. The associations between the baseline urinary A-megalin measured by the novel method and/or C-megalin levels and the subsequent estimated glomerular filtration rate (eGFR) slope were analyzed using a generalized estimating equation. Patients were categorized into higher or lower groups based on the optimal cutoff values, obtained from a receiver operating characteristic (ROC) curve, of the two forms of urinary megalin. Results Urinary A-megalin levels measured by the two methods were strongly correlated. The eGFR slopes of the higher A-megalin and C-megalin groups were −0.904 (95% confidence interval [CI] −1.584, −0.224) and −0.749 (95% CI −1.312, −0.186) ml/min/1.73 m2 per year steeper than those of the lower groups, respectively. Moreover, the eGFR slope was −1.888 (95% CI −2.764, −1.011) ml/min/1.73 m2 per year steeper in the group with both higher A- and higher C-megalin than in the other groups. These results remained significant when adjusted for albuminuria or known tubular injury markers. Conclusions Our novel method allows urinary A-megalin measurements to be performed more easily. Baseline urinary megalin levels were associated with the subsequent eGFR slope independently of known biomarkers in type 2 diabetes patients not receiving SGLT2 inhibitors. These two forms of megalin may be distinct urinary biomarkers of the progression of DKD.

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