Category: Diabetes/Prediabetes/Hypoglycemia

GLYCEMIC OUTCOMES OF SGLT2 INHIBITORS IN OVERWEIGHT OR OBESE TYPE 2 DIABETES PATIENTS

Monday, Apr 8
1:00 AM – 2:00 AM

Objective : To evaluate the glycemic outcome of SGLT2 (sodium-glucose cotransporter type 2) inhibitors in overweight or obese patients with type 2 diabetes mellitus  


Methods :

The current study was a multicentre retrospective data analysis of T2DM patients initiated on treatment with SGLT2i as an add-on to other anti-hyperglycaemic agents. The data is extracted from Apollo Sugar Clinics, electronic medical records registered from January 2016 to July 2018. Apollo Sugar Clinics is a large comprehensive healthcare system in India serving patients with diabetes. A total of 3559 SGLT2i prescriptions were selected from EMR for the analysis and were grouped into canagliflozin (GC), dapagliflozin (GD) and empagliflozin (GE). Descriptive statistics were applied to calculate the mean (standard deviation) and frequency (percentage) for continuous and discrete variables. Appropriate statistical tests were used to observe the clinical and statistical difference in clinical outcomes among different SGLT2i, p ≤0.05 is considered to be significant.


Results : Mean (SD) age was 52.1 (10.6) years, males 57.7% and females 42.3%. Among 3559 SGLT2i prescriptions 14% were on GC, 39% on GD, 47% on GE. The majority (95.1%) of these patients were either overweight or obese. At initiation the mean HBA1c was 8.6(1.8)%, fasting blood glucose 165(59) mg/dL and post-prandial 242(87) mg/dL. To assess clinical outcomes patients with follow up HbA1c, body mass index (BMI), weight and SGLT2 prescriptions were included which were 618 obese patients. Among these patients, there was a significant mean difference in HbA1c (-0.6%), BMI (-0.5 kg/m2), and weight (-1.2 kgs) from baseline to follow up in an average time interval of 120days. Moreover, in SGLT2i groups, BMI reduction was highest in GE (0.7kg/m2) compared to GD (0.5 kg/m2) and GC (0.1kg/m2), significant at p<0.02. High BMI reduction in GE group reflects in high (29.1%) percentage of patients at HbA1c <7% compared to GD (23.8%) and GC (28.3%). However, the mean difference in Hba1c, FBG, PPBG and weight among three groups was clinically considerable. 


Discussion :

The analysis shows significant reduction in HbA1c, BMI and weight in patients with T2DM on SGLT2i treatment. Importantly, in patients treated with empagliflozin there was high BMI reduction and high percentage of patients were at HbA1c


Conclusion : SGLT2i are new class of drugs that showed improvement in blood glucose and BMI in patients with T2DM in real clinical practice.   

SHORT URL FUNCTION-->

Balaji Jaganmohan

Consultant Diabetologist
Apollo Sugar Clinics Limited., India

Dr. Balaji Jagan Mohan is a Consultant Physician and Diabetologist at Apollo Sugar Clinic, Bangalore. He provides treatment for conditions such Diabetes Mellitus, Hypertension, Dyslipidemia, Obesity, Thyroid disorders, Screens and treats Microvascular and Macrovascular Complications of Diabetes like Diabetic neuropathy, nephropathy, retinopathy and Diabetic foot diseases. Apart from this, he has many publications and research work to his credit. He holds membership of associations and societies that are related to his field of practice. He is an enthusiastic learner and that is why he never misses a chance to attend any conference or seminar that take place within his reach. He completed MD in General Medicine from UMFT University, Romania, European Union and Postgraduate Diploma in Diabetes from Cardiff University (UK) and Fellowship in Diabetology from Dr. Mohans Diabetic Centre (Chennai).

Venkataraman S

Senior Consultant Diabetologist
Apollo Sugar Clinic, Apollo Hospital, India

Dr. S. Venkataraman is a Sr. Consultant Diabetologist practicing at Apollo Sugar Clinics, Greamsroad Chennai. He is a highly experienced diabetologist with more than 25 years of experience in treating all types of diabetes. Over the years, he has numerous publications to his credit. Apart from that, he has huge academic experience as a Professor of Diabetology and has taught in Madurai Medical College, and Rajaji Hospital, Maduria, and Madras Medical College. He received an award from IDF (International Diabetes Federation) for his paper on Pregnancy and Diabetes.

Sambit Das

Endocrinologist and Diabetologist
Apollo Sugar Clinic, Apollo Hospital
Bhubaneswar

Dr. Sambit Das is an eminent Endocrinologist and Diabetologist in the state of Orissa, currently practising at Apollo Hospitals in Bhubaneswar, and at Dr.Sambit’s Centre of Diabetes and Endocrinology, N-4/18, IRC Village, Nayapali, Bhubaneswar.

Dr. Sambit Das excelled in academics right from his school days, and remained a topper during his medical studies as well, being awarded Gold Medals in several subjects during the MBBS programme and bagging the Best Graduate Award at the Final MBBS examination in 2001. Dr. Sambit Das went on to obtain the MD postgraduate degree in Internal Medicine in 2006, passing all the exams at first attempt. Then after completing a brief stint as Senior Resident in Endocrinology at SGPGI Lucknow in 2006, Dr. Das obtained the DM Endocrinology superspeciality degree from the prestigious PGIMER Chandigarh in 2009.

Dr. Sambit Das has been with Apollo Hospitals as Consultant Endocrinologist and Diabetologist since April 2010. He also received the adjunct title of Associate Professor in Endocrinology from Apollo Health and Educational Research Foundation (AHERF) Medvarsity in 2013. Dr. Das has been associated with several research projects, and his research papers have been published in reputed journals. He has delivered innumerable lectures and presentations at conferences in India and internationally, and is a regular invitee as Faculty at prominent events relating to his field of specialisation.

Dwarakanath CS

Senior Endocrinologist
Apollo Sugar Clinic, Apollo Hospital, India

Dr. Dwarakanath C.S. is a Endocrinologist in Basavanagudi, Bangalore and has an experience of 31 years in this field. Dr. Dwarakanath C.S. practices at Surya Endocrine Diabetes Centre in Basavanagudi, Bangalore, Surya Endocrine Diabetes Centre in Nagarbhavi, Bangalore and Apollo Sugar Clinic in Bannerghatta Road, Bangalore. Completed MBBS from JJMMC, Davanagere in 1984,MD - Medicine from Mysore Medical College, Mysore in 1988 and DM - Endocrinology from All India Institutes of Medical Sciences, AIIMS, New Delhi in 1996. Member of Karnataka Medical Council and Indian Medical Association (IMA).

Sanjiv Shah

Senior Endocrinologist and Diabetologist
Apollo Sugar Clinics, India

Nil

Vikrant Tari

Diabetologist
Apollo Sugar Clinics, India

Nil

Narendra Bs

Diabetologist, Endocrinologist
Apollo Sugar Clinic, Apollo Hospital, India

Nil

Manikandan Rm

Endocrinologist & General Physician
Apollo Sugar Clinic, Apollo Hospital, India

Nil

Vamsi Krishna Kolukula

Head, Clinical Excellence
Apollo Sugar Clinics Limited., India

Nil

Shashank Joshi

Senior Endocrinologist
Lilavati and Bhatia Hospital
Mumbai, Maharashtra, India

Prof Shashank R. Joshi MD, DM, FACP, FACE, FRCP
Endocrinologist, Lilavati & Bhatia Hospital
Consultant and Advisor, Apollo Sugar Clinics
President, Indian Academy of Diabetes, Past President, Endocrine Society of India
Past President, Research Society for Study of Diabetes in India(RSSDI)
Past President, All India Association for Advancement of Research in Obesity Past President, Association of Physicians of India, Emeritus Editor, JAPI
Indian Chapter Chair, AACE
He was honored by the Government of India, in 2014, by bestowing on him the Padma Shri, the fourth highest civilian award, for his services to the field of medicine. He is also a recipient of the International Clinician Award, received at the 21st American Association of Clinical Endocrinologists (AACE) Annual Scientific and Clinical Congress, Philadelphia. This is an annual award given to practicing endocrinologists, outside the US