High-dose SGLT2 inhibitors tied to superior blood sugar control in type 2 diabetes: Study
China: The use of clinically approved high-dose SGLT2 inhibitors may help in improving blood sugar levels, body weight and blood pressure in patients with poorly controlled diabetes, suggests a recent study.
The study, published in the journal Diabetes, Obesity & Metabolism, found that the overall efficacy of SGLT2 inhibitors mainly empagliflozin, dapagliflozin, and canagliflozin is dose-dependent.
Sodium-glucose co-transporter 2 (SGLT2) inhibitors are a new class of oral hypoglycaemic drugs. It is initially recommended to diabetes patients with cardiovascular disease or to those previously subjected to metformin-based treatment. SGLT2 inhibitors exert beneficial effects on the regulation of blood pressure, body weight, and blood sugar. However, it is not certain whether the effects are dose-dependent.
To fill this knowledge gap, Zhi-Chun Gu, Shanghai Jiaotong University, Shanghai, China, and colleagues aimed to determine the overall efficacy of high-dose versus low-dose SGLT2 inhibitors in patients with type 2 diabetes mellitus (T2DM).
For this purpose, the researchers searched the online databases between 1 January 2006 and 23 September 2020. Prespecified subgroup analyses for each SGLT2 inhibitor, follow-up, and controls were performed. Leave-one-out sensitivity and meta-regression analyses were conducted. The meta-analysis included a total of 51 randomized controlled trials involving 23989 participants.
Key findings of the study include:
- For glycaemic regulation ability, a significant reduction in glycosylated haemoglobin (MD –0.080%), fasting plasma glucose (MD –0.227 mmol/L), and postprandial plasma glucose (MD –0.834 mmol/L) levels was observed in the high-dose SGLT2 inhibitor group.
- Treatment with high-dose SGLT2 inhibitors enabled easier achievement of the target (HbA1c% < 7) than low-dose SGLT2 inhibitors (RR 1.148).
- High-dose SGLT2 inhibitor-based treatment resulted in more efficient regulation of body weight and blood pressure (body weight: MD –0.346 kg; SBP: MD –0.583 mmHg; DBP: MD –0.352 mmHg).
- The results were similar in sensitivity analyses.
"Our findings showed that the overall efficacy of SGLT2 inhibitors, mainly canagliflozin, dapagliflozin, and empagliflozin are dose-dependent," concluded the authors.
The study titled, "High-Dose Sodium-Glucose Co-transporter 2 Inhibitors are Superior in Type 2 Diabetes: A Meta-analysis of Randomised Clinical Trials," is published in the journal Diabetes, Obesity & Metabolism.