Nada Aml Mohamed, Younan Mariam Adel
Assistant Professor of Internal Medicine and Endocrinology, Faculty of Medicine, Mansoura University, Elgomhouria Street, Mansoura City, 35116, Egypt.
Assistant Professor of Clinical Pathology, Cairo Medical School, Kasr Al-Ainy, Egypt; Specialist Clinical Pathologist, Zulekha Hospital, Sharjah, UAE.
Ther Adv Endocrinol Metab. 2021 Mar 16;12:2042018821995364. doi: 10.1177/2042018821995364. eCollection 2021.
Dapagliflozin is a sodium-glucose co transporter-2 inhibitor that proved efficacy in reduction of blood glucose level through extrusion of glucose in urine. It is used in treatment of type 2 diabetes mellitus (T2DM). It also has reported cardiovascular and renal benefits in patients with T2DM. Data are very limited about its effects in Emirati patients with diabetes. Our aim was to evaluate dapagliflozin treatment in Emirati patients with T2DM.
This is a retrospective study involving 89 diabetes patients who were using dapagliflozin 10 mg once daily as add-on therapy for 12 months. All patients had T2DM, aged over 18 years and had an estimated glomerular filtration rate (eGFR) over 60 ml/min/1.73 m². Body weight, height, body mass index, sitting blood pressure and heart rate were collected. Fasting plasma glucose, glycosylated hemoglobin (HbA1c), lipid profile and other available biochemical parameters, for example, creatinine, blood urea nitrogen, and urine albumin/creatinine ratio were traced from medical records and eGFR was calculated.
Patients were aged 62.3 ± 9.4 years with a median duration of diabetes of 15 (10-20) years. Data were analyzed before, at 6 months and 12 months of treatment. Fasting plasma glucose, HbA1c, body mass index, systolic and diastolic blood pressure significantly decreased ( = 0.002, < 0.0005, < 0.002, < 0.0005, < 0.0005, respectively). The median reduction of HbA1c was 0.7% (0.2-1.2) and 0.9% (0.5-1.8) at 6 and 12 months, respectively. Systolic blood pressure decreased by a median of 7 mmHg (4-20 mmHg) and 9 mmHg (1-10 mmHg) on the 6th and 12th month of treatment, respectively, while the diastolic decreased by a median of 3 mmHg (4 to 10 mmHg) and 6 mmHg (1-10 mmHg); without increase in heart rate ( = 0.188). A significant reduction of body mass index, C-reactive protein and rate pressure product was noticed ( = 0.002, = 0.001, < 0.0005, respectively). No decline in eGFR or microalbuminuria was noticed. Stage I chronic kidney disease with eGFR < 90 ml/min/1.73 m² showed continuous progressive reduction of HbA1c without a significant change in other variables.
Our data indicate improved cardiovascular risk profile in dapagliflozin-treated Emirati patients with T2DM.
达格列净是一种钠-葡萄糖协同转运蛋白2抑制剂，已证实其可通过促进尿糖排泄来降低血糖水平，用于治疗2型糖尿病（T2DM）。据报道，它对T2DM患者还有心血管和肾脏保护作用。关于其在阿联酋糖尿病患者中的作用的数据非常有限。我们的目的是评估达格列净治疗阿联酋T2DM患者的效果。
这是一项回顾性研究，纳入了89例糖尿病患者，他们每日一次服用10 mg达格列净作为附加治疗，为期12个月。所有患者均为T2DM患者，年龄超过18岁，估计肾小球滤过率（eGFR）超过60 ml/min/1.73 m²。收集患者的体重、身高、体重指数、坐位血压和心率。从病历中追踪空腹血糖、糖化血红蛋白（HbA1c）、血脂谱和其他可用的生化参数，如肌酐、血尿素氮和尿白蛋白/肌酐比值，并计算eGFR。
患者年龄为62.3±9.4岁，糖尿病病程中位数为15（10 - 20）年。在治疗前、治疗6个月和12个月时对数据进行分析。空腹血糖、HbA1c、体重指数、收缩压和舒张压均显著降低（分别为P = 0.002、P < 0.0005、P < 0.002、P < 0.0005、P < 0.0005）。HbA1c在6个月和12个月时的中位数降幅分别为0.7%（0.2 - 1.2）和0.9%（0.5 - 1.8）。治疗第6个月和12个月时，收缩压中位数分别下降7 mmHg（4 - 20 mmHg）和9 mmHg（1 - 10 mmHg），舒张压中位数分别下降3 mmHg（4至10 mmHg）和6 mmHg（1 - 10 mmHg）；心率无增加（P = 0.188）。体重指数、C反应蛋白和心率血压乘积显著降低（分别为P = 0.002、P = 0.001、P < 0.0005）。未观察到eGFR或微量白蛋白尿下降。eGFR < 90 ml/min/1.73 m²的I期慢性肾脏病患者HbA1c持续逐步降低，其他变量无显著变化。
我们的数据表明，接受达格列净治疗的阿联酋T2DM患者的心血管风险状况有所改善。
