Effect of Dapagliflozin on Glycemic Control, Weight, and Blood Pressure in Patients with Type 2 Diabetes Attending a Specialist Endocrinology Practice in Canada: A Retrospective Cohort Analysis

• Published in: Diabetes technology & therapeutics Vol. 19; no. 11; p. 685
• Main Authors: Brown, Ruth E, Gupta, Nikhil, Aronson, Ronnie
• Format: Journal Article
• Language: English
• Published: United States 01.11.2017
• Subjects: Aged; Benzhydryl Compounds - administration & dosage; Benzhydryl Compounds - therapeutic use; Blood Glucose - analysis; Blood Pressure - drug effects; Body Weight - drug effects; Canada; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - physiopathology; Drug Therapy, Combination; Female; Glucosides - administration & dosage; Glucosides - therapeutic use; Humans; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - therapeutic use; Male; Metformin - therapeutic use; Middle Aged; Registries; Retrospective Studies; Treatment Outcome; Canada; Retrospective analysis; Type 2 diabetes mellitus; Dapagliflozin; Hemoglobin A1c; Real-world evidence; Tertiary healthcare
• ISSN: 1557-8593
• DOI: 10.1089/dia.2017.0134

In randomized clinical trials, dapagliflozin has been shown to improve glycemic control, weight, and blood pressure. However, there is little real-world evidence of the effectiveness of dapagliflozin. The objective of this study is to investigate the real-world treatment outcomes of patients with type 2 diabetes (T2D) who initiated dapagliflozin in a referral-based endocrinology practice. This study was a retrospective cohort analysis of patients with T2D who initiated dapagliflozin in 2015, using data from a large, specialist diabetes registry in Canada. 1520 patients were eligible for analysis. Following 3 to 6 months of treatment, hemoglobin A1c (HbA1c) decreased by a mean of 0.9% ± 1.3% (9.8 ± 14.2 mmol/mol) (P < 0.01), weight decreased 2.2 ± 3.1 kg (P < 0.01), and systolic blood pressure decreased 3.7 ± 14.3 mmHg (P < 0.01). The proportion of patients who achieved glycemic control (HbA1c ≤7.0%) increased from 7.0% at baseline to 27.0% during follow-up. There was also a statistically significant decrease from baseline in body mass index, diastolic blood pressure, fasting glucose, total cholesterol, low-density lipoprotein cholesterol, triglycerides, alanine aminotransferase, and the proportion of patients with microalbuminuria (P < 0.01). A higher baseline HbA1c, shorter duration of diabetes, male gender, and greater weight loss were each independently associated with a greater reduction in HbA1c (P < 0.01). In a real-world clinical setting in Canada, dapagliflozin produced significant improvements in HbA1c, weight, and blood pressure in patients with T2D, comparable to that seen in randomized clinical trials.