Deogiri Diabetic Care Centre; Corresponding Author.
Madhumeha Chikitsalaya, Rachanakar Colony.
J Assoc Physicians India. 2022 Jun;70(6):11-12. doi: 10.5005/japi-11001-0001.
There are a handful of sodium glucose co-transporter 2 (SGLT2) inhibitors available in the global and Indian markets to manage type II diabetes mellitus (T2DM). However, head-to-head comparison between different SGLT2 inhibitors is scarce. Therefore, the present study was aimed to analyze the effect of different SGLT2 inhibitors on glycemic control and body weight in Indian patients with T2DM.
This was a prospective, interventional, nonrandomized study that included patients (N = 480) of either sex, aged ≥30 years, with inadequately controlled T2DM having HbA1c > 8.5%, and were receiving either Canagliflozin, Empagliflozin, Dapagliflozin or Remogliflozin on the background of triple-drug therapy. In this study, patients were evaluated for HbA1c, fasting blood sugar (FBS), post-prandial blood sugar (PPBS), body weight, and systolic and diastolic blood pressure at baseline, 12 and 24 weeks.
A total of 480 patients who received either Canagliflozin (n = 120), Empagliflozin (n = 120), Dapagliflozin (n = 120), or Remogliflozin (n = 120) were included in this study. There was a significant reduction in levels of HbA1c, FBS, PPBS, body weight, systolic blood pressure (SBP), and diastolic blood pressure (DBP) at week 12 and 24 in all treatment groups. The difference in mean values of glycemic parameters and body weight was comparable across the treatment groups at week 12 and 24 but was not significant. Out of all 480 patients, 10 patients (2.08%) reported urinary tract infection (UTI), and five (1.04%) reported genital mycotic infection. All the five patients were females and treatment for UTI and mycotic infection was provided as required. Rest of the patients tolerated the therapy well.
Overall observations indicate that all the four SGLT2 inhibitors are effective in reducing HbA1c, FBS, PPBS, body weight SBP, and DBP. Therefore, gliflozins can be the best choice to start early in patients with inadequately controlled T2DM receiving triple-drug therapy which helps in controlling the parameters of glycemia and significantly reducing the body weight. Hence SGLT2 Inhibitors could be considered as an add-on to all antidiabetic agents currently used for the management of diabetes in Indian setting.
目前，全球和印度市场上有几种钠-葡萄糖协同转运蛋白 2（SGLT2）抑制剂可用于治疗 2 型糖尿病（T2DM）。然而，不同 SGLT2 抑制剂之间的头对头比较很少。因此，本研究旨在分析不同 SGLT2 抑制剂对印度 T2DM 患者血糖控制和体重的影响。
这是一项前瞻性、干预性、非随机研究，纳入了年龄≥30 岁、接受三药治疗的性别不限的 T2DM 患者（N=480），其糖化血红蛋白（HbA1c）>8.5%，正在服用卡格列净、恩格列净、达格列净或瑞格列净。在这项研究中，患者在基线、12 周和 24 周时接受了糖化血红蛋白（HbA1c）、空腹血糖（FBS）、餐后血糖（PPBS）、体重、收缩压和舒张压的评估。
共有 480 名患者接受了卡格列净（n=120）、恩格列净（n=120）、达格列净（n=120）或瑞格列净（n=120）治疗，纳入本研究。所有治疗组在 12 周和 24 周时 HbA1c、FBS、PPBS、体重、收缩压（SBP）和舒张压（DBP）水平均显著降低。12 周和 24 周时，各治疗组间血糖参数和体重的均值差异无统计学意义。在所有 480 名患者中，有 10 名（2.08%）患者报告尿路感染（UTI），5 名（1.04%）患者报告生殖器真菌感染。所有 5 名患者均为女性，根据需要进行了 UTI 和真菌感染的治疗。其余患者均耐受治疗。
总体观察表明，所有 4 种 SGLT2 抑制剂均能有效降低 HbA1c、FBS、PPBS、体重、SBP 和 DBP。因此，在接受三药治疗的血糖控制不佳的 T2DM 患者中，早期使用格列净类药物可作为最佳选择，有助于控制血糖参数，并显著减轻体重。因此，SGLT2 抑制剂可被视为印度目前用于管理糖尿病的所有抗糖尿病药物的附加药物。
