内分泌学とメタボリックシンドローム
オープンアクセス
ISSN: 2161-1017
ISSN: 2161-1017
Subhash Kumar*
Objective and Aim: Uncontrolled diabetic patients were increasing day by day despite availability of multiple oral antidiabetic drugs. The main objective of the study was to evaluate the efficacy of dapagliflozin 10 mg on Indian subjects who were uncontrolled despite on multiple (≥4) oral antidiabetic drugs.
Methods: Patients treated with Dapagliflozin 10 mg as an add-on drug, on those patients who were poorly controlled despite optimum doses of more of equal to four OADs, metformin, sulfonylureas, pioglitazone, hydroxychloroquine, DPP-4 inhibitor and alpha-glycosidase inhibitors were included in this analysis. Total 245 patients with ≥ 3 regular follow-ups visiting a Diabetes Specialty Clinic were considered for this retrospective analysis.
Results: The mean Fasting Blood Glucose (FPG) was 168.4 ± 19.8 mg/dl and mean Post Prandial Glucose (PPG) was 238.3 ± 28.6 mg/dl. The mean baseline HbA1c was 8.4 ± 1.2 %. The mean duration required to control diabetes with dapagliflozin 10 mg was 7.9 weeks. 83.5% of the total cases responded to treatment with a DPP-4i (P <0.05). The response in age group <55 years was 90.3%, whereas in ≥ 55 years group, it was 83.3%. Those with BMI <23.5 kg/m2 had significantly higher response (94.6%) as compared to 82.3% in patients with BMI ≥ 23.5 kg/m2. At the end of the monitoring period, there was significant reduction in mean FPG by-31.4 ± 18.3 mg/dL (P=0.001), mean PPG by -64.8 ± 21.3 mg/dL (P=0.001), mean HbA1c by -1.3 ± 0.8 (P= 0.001), weight by -1.2 kg (P=0.001), mean SBP by -3.6 mmHg (p=0.01) and mean DBP by -2.0 mmHg (p=0.01). Common adverse events included hypoglycemia, pollakiuria, and thirst. But none required a medical assistance.
Conclusion: Dapagliflozin is effective in achieving the desired glycemic control. Early initiation of dapagliflozin is recommended for tighter glycemic control.