Tamez-Perez Héctor Eloy, Delgadillo-Esteban Enrique, Soni-Duque David, Hernández-Coria Mayra Ivonne, Tamez-Peña Alejandra Lorena
Subdirección de Investigación, Facultad de Medicina. Universidad Autónoma de Nuevo León, Dr. Aguirre Pequeño, Mitras Centro, C.P. 64460 Monterrey, Nuevo León Mexico.
División de Medicina Interna "Modelo Nova", Clínica Nova, Monterrey, Nuevo León Mexico.
J Diabetes Metab Disord. 2017 Jun 30;16:27. doi: 10.1186/s40200-017-0308-4. eCollection 2017.
Type 2 diabetes mellitus (T2DM) is a progressive chronic disease associated with severe microvascular and macrovascular complications. Our aim is to assess the real world effectiveness of SGT" inhibitors in achieving metabolic therapeutic goals.
A retrospective, observational study. Inclusion criteria for patients were a previous diagnosis of type 2 diabetes mellitus, age > 18 years, patients receiving either dapagliflozin 10 mg and/or canagliflozin 300 mg. We excluded pregnant patients, patients with type 1 diabetes mellitus and acute metabolic complications of diabetes. Patients included in the analysis were enrolled in a health plan at least 6 months prior to the index date (baseline period) and in the 6 months following the index date (follow-up period). Achievement of glycated hemoglobin goals were established as <7%.
We screened 2870 Mexican patients; 288 (10.03% received SGLT2 inhibitors). Mean age for both groups of patients was 57.68 ± 11.06 years. The dapagliflozin control rate was 19.56% and the canagliflozin control rate 18.96%. Monotherapy with SGLT2 inhibitors was used in 21 patients (6.25%). Overall HbA1c goals were met in 56 patients (19.44%) with similar results with dapagliflozin or canagliflozin. The combination of SGLT2 inhibitors and sulfonylureas had the highest control rate (30.30%) compared to other regimens. Monotherapy was present in 6.25%. Insulin requirement was associated with poor control (2.8% vs. 18.05%, < 0.05, 95% CI [0.07, 0.84]). Combination therapy with DPP4 inhibitors was associated with better control ( < 0.05, 95% CI, [1.10, 3.92]).
No difference between the drugs was observed. Real-world effectiveness data of SGLT2 inhibitors show that the percentage of patients reaching metabolic goals is low. SLGT2 inhibitors were used more frequently as combined therapy.
2型糖尿病（T2DM）是一种进展性慢性疾病，与严重的微血管和大血管并发症相关。我们的目的是评估钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂在实现代谢治疗目标方面的真实世界有效性。
一项回顾性观察性研究。患者的纳入标准为既往诊断为2型糖尿病、年龄>18岁、接受达格列净10mg和/或卡格列净300mg治疗的患者。我们排除了孕妇、1型糖尿病患者和糖尿病急性代谢并发症患者。纳入分析的患者在索引日期（基线期）前至少6个月以及索引日期后的6个月（随访期）加入了一项健康计划。糖化血红蛋白目标的达成设定为<7%。
我们筛查了2870名墨西哥患者；288名（10.03%）接受了SGLT2抑制剂治疗。两组患者的平均年龄为57.68±11.06岁。达格列净的控制率为19.56%，卡格列净的控制率为18.96%。21名患者（6.25%）使用SGLT2抑制剂单药治疗。56名患者（19.44%）达到了总体糖化血红蛋白目标，达格列净或卡格列净的结果相似。与其他治疗方案相比，SGLT2抑制剂与磺脲类药物联合使用的控制率最高（30.30%）。单药治疗占6.25%。胰岛素需求与控制不佳相关（2.8%对18.05%，P<0.05，95%CI[0.07，0.84]）。与二肽基肽酶-4（DPP4）抑制剂联合治疗与更好的控制相关（P<0.05，95%CI，[1.10，3.92]）。
未观察到药物之间的差异。SGLT2抑制剂的真实世界有效性数据表明，达到代谢目标的患者百分比很低。SGLT2抑制剂更常作为联合治疗使用。
