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KMID : 1141520190340010070
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Endocrinology and Metabolism
2019 Volume.34 No. 1 p.70 ~ p.79
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Retrospective Analysis of the Efficacy of Dapagliflozin in Patients with Type 2 Diabetes in a Primary Clinic in Korea
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Park Sang-Hyun
Choi Young-Ju
Rhee Eun-Jung
Huh Kab-Bum
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Abstract
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Background: We aimed to retrospectively analyze the efficacy of 10 mg dapagliflozin (DAPA), which is a sodium-glucose cotransporter-2 inhibitor, in Korean patients with type 2 diabetes who visited a primary diabetes clinic.
Methods: In total, 83 patients with type 2 diabetes, who received treatment with DAPA for the first time in a primary diabetes clinic between January 2015 and October 2015, were included in the study. The effect of DAPA in lowering glycosylated hemoglobin (HbA1c) levels was evaluated via chart review at 6 months follow-up. The patients were categorized into five groups according to add-on to or switched from other glucose-lowering agents: add-on to metformin (MET, n=10), add-on to MET+dipeptidyl peptidase 4 inhibitor (DPP4i, n=12), switched from sulfonylurea (SU, n=13), switched from DPP4i (n=11), and switched from thiazolidinedione (TZD, n=37). All the participants had already used MET for their regimen.
Results: Treatment with DAPA reduced HbA1c level by 1.2%±0.8%. Moreover, a significant decrease was observed in all subgroups: add-on to MET, ?1.2%±0.7%; add-on to MET+DPP4i, ?1.4%±0.8%; switched from SU, ?1.4%±0.7%; switched from DPP4i, ?0.5%±0.7%; and switched from TZD, ?1.2%±0.9% (P<0.01). A significant decrease in body weight (?3.1±2.6 kg, P<0.001) was observed after DAPA administration. Estimated glomerular filtration rate and urine microalbumin were significantly decreased after 6 months of treatment with DAPA (?4.0±13.5 mL/min/1.73 m2,P=0.03; ?23.6±45.9 mg/L, P<0.001).
Conclusion: Treatment with DAPA, whether added to or switched from other glucose-lowering agents, significantly decreased HbA1c levels in Korean patients with type 2 diabetes who visited a single primary diabetes clinic. DAPA can be considered as an optimal second-line treatment for patients with type 2 diabetes, as supported by real-world evidence studies.
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KEYWORD
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Diabetes mellitus, type 2, Dipeptidyl-peptidase IV inhibitors, Dapagliflozin, Primary health care, Retrospective studies
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