All SGLT-2 inhibitors found promising for diabetes management in Indian settings: JAPI
Maharashtra: SGLT2 Inhibitors could be considered as an add-on to all antidiabetic agents currently used for diabetes management in the Indian setting, researchers from Maharashtra have reported.
In their study, published in the Journal of the Association of Physicians of India, they found that all the four SGLT2 inhibitors (Canagliflozin, Empagliflozin, Dapagliflozin, or Remogliflozin) are effective in reducing fasting blood sugar (FBS), HbA1c, body weight, post-prandial blood sugar (PPBS), and both systolic and diastolic blood pressure. Therefore, SGLT2 inhibitors or gliflozins can be the best choice to start early in patients with inadequately controlled type 2 diabetes mellitus (T2DM) receiving triple-drug therapy. This helps in significant weight reduction and controlling all parameters of glycemia.
For the management of type 2 diabetes, a handful of sodium-glucose co-transporter 2 (SGLT2) inhibitors are available in the Indian and global markets. However, there is a scarcity of head-to-head comparisons between different SGLT2 inhibitors. To fill this knowledge gap, Deepak Bhosle, Deogiri Diabetic Care Centre, Aurangabad, Maharashtra, India, and colleagues aimed to analyze the effect of different SGLT2 inhibitors on glycemic control and body weight in Indian patients with T2DM in a prospective, interventional, nonrandomized study.
The study included patients (N = 480) of either sex, aged ≥30 years, with inadequately controlled T2DM having HbA1c > 8.5%, and were receiving either Canagliflozin, Dapagliflozin, Empagliflozin, or Remogliflozin on the background of triple-drug therapy. In the study, patients were evaluated for HbA1c, fasting blood sugar, postprandial blood sugar, body weight, and systolic and diastolic blood pressure at baseline,12 and 24 weeks.
The study included a total of 480 patients who received either Canagliflozin (n = 120), Dapagliflozin (n = 120), Empagliflozin (n = 120), or Remogliflozin (n = 120).
The findings of the study were as follows:
- There was a significant reduction in levels of HbA1c, FBS, PPBS, body weight, systolic blood pressure (SBP), and diastolic blood pressure (DBP) at weeks 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 weeks 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. The rest of the patients tolerated the therapy well.
"The findings suggest that all four gliflozins were similarly effective in achieving target glycemic levels and reduction in body weight. Also, a reduction in blood pressure was observed with the use of all four gliflozins," wrote the authors.
"Gliflozins, therefore, can be a possible choice for the management of diabetes in Indian settings," they concluded.
Reference:
Bhosle D, Indurkar S, Quadri U, et al. A Comparative Study of efficacy and safety of different Sodium Glucose Co-transporter 2 (SGLT-2) Inhibitors in the Management of Patients with Type II Diabetes Mellitus. J Assoc Physicians India 2022;70(6):52–55
