Metformin and SGLT2 Inhibitor combo helps attain HbA1c of <8% in most Diabetics

Written By : Dr.Niharika Harsha B |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2020-06-18T10:44:56+05:30 | Updated On 18 Jun 2020 2:52 PM IST

Complex pathophysiology and multiple physiological factors play a key role in the onset and the progression of Diabetes Mellitus. Combination therapy rather than monotherapy plays a major role in the management of the disease (1). Out of these Metformin, a biguanide is the first line of treatment for type 2 diabetes mellitus. Another novel class of oral anti diabetic agents are Sodium glucose cotransporter 2 inhibitors (SGLT2i). Metformin and SGLT2 Inhibitor Dual Therapy in attaining the HbA1c threshold of <8% was done in the United States, states a study.

Published in the journal of Diabetes in June 2020,by Dominik Lautsch et al, the study aimed to determine factors associated with attaining the HbA1c threshold of <8% in the United States. The study was Observational, retrospective cohort study in adult type 2 diabetes mellitus patients. Data was collected from IQVIA EMR database. Observation period was June 2015 to June 2018. For this Patients needed to initiate SGLT2i and metformin without other antihyperglycemic agents. The impact of sociodemographic factors on achievement of HbA1c <8% was tested using multivariable logistic regression with backward stepwise selection using SAS 9.4.

From the study the authors found that

• Out of 3491 patients in the final cohort, 2176 (62.3%) achieved HbA1c <8%.

• The remaining patients had a median distance to goal of 1.1% (IQR 0.5-2.3%)

• Mean age of the patients was 56.5 year

• Out of them 52.6% were male and 47.4% were females.

• In total there were 74.5% whites, 2% Asians, 13.7% Blacks, 8.5% were unknown

• Of the total patients 13% were smokers and 8.3% with established chronic kidney or cardiovascular disease.

• Black patients had lower odds to attain HbA1c <8% than white patients [OR 0.69 (0.57, 0.85)]

• While patients <65 years of age had non relevant higher odds [OR 1.01 (1.01, 1.02)]

From this study the authors concluded that in the real world in the U.S., 62% of patients treated with metformin and SGLT2i had an HbA1c <8%. Black patients had lower odds to attain this threshold.

The authors said that this study was funded by Merck & Co., Inc.

(1) Kalra S, Kesavadev J, Chadha M, Kumar GV. Sodium-glucose Cotransporter-2 Inhibitors in Combination with Other Glucose-lowering Agents for the Treatment of Type 2 Diabetes Mellitus. Indian J Endocrinol Metab. 2018;22(6):827-836.

diabetesmetforminSGLT2 inhibitordiabetes drugglycemic controlsodium glucose cotransporter 2

Source : American Diabetes Association 80th Scientific session

Dr.Niharika Harsha B

BDS, MDS

Dr.Niharika Harsha B (BDS,MDS) completed her BDS from Govt Dental College, Hyderabad and MDS from Dr.NTR University of health sciences(Now Kaloji Rao University). She has 4 years of private dental practice and worked for 2 years as Consultant Oral Radiologist at a Dental Imaging Centre in Hyderabad. She worked as Research Assistant and scientific writer in the development of Oral Anti cancer screening device with her seniors. She has a deep intriguing wish in writing highly engaging, captivating and informative medical content for a wider audience. She can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751