Dapagliflozin improves cardiovascular risk factors in Emirati patients with T2DM

Aml Mohamed Nada; Mariam Adel Younan

doi:10.1177/2042018821995364

Dapagliflozin improves cardiovascular risk factors in Emirati patients with T2DM

Ther Adv Endocrinol Metab. 2021 Mar 16:12:2042018821995364. doi: 10.1177/2042018821995364. eCollection 2021.

Authors

Aml Mohamed Nada¹, Mariam Adel Younan²

Affiliations

¹ Assistant Professor of Internal Medicine and Endocrinology, Faculty of Medicine, Mansoura University, Elgomhouria Street, Mansoura City, 35116, Egypt.
² Assistant Professor of Clinical Pathology, Cairo Medical School, Kasr Al-Ainy, Egypt; Specialist Clinical Pathologist, Zulekha Hospital, Sharjah, UAE.

Abstract

Background: 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.

Patients and methods: 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.

Results: 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 (p = 0.002, p < 0.0005, p < 0.002, p < 0.0005, p < 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 (p = 0.188). A significant reduction of body mass index, C-reactive protein and rate pressure product was noticed (p = 0.002, p = 0.001, p < 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.

Conclusion: Our data indicate improved cardiovascular risk profile in dapagliflozin-treated Emirati patients with T2DM.

Keywords: CKD; HbA1c; SGL2i; cardiovascular; dapagliflozin; microalbuminuria.