Changes in HbA1c and weight in type 2 diabetes patients initiating dapagliflozin treatment in routine UK primary care

J.P.H. Wilding, C.J. Bailey, U. Rigney, B. Blak, W. Beekman, C.E. Emmas

Research output: Contribution to journalConference abstract

Abstract

Background and aims: Dapagliflozin is a sodium-glucose cotransporter-2 (SGLT2) inhibitor that lowers blood glucose in type 2 diabetes(T2DM) by reducing renal glucose reabsorption. This study examines the characteristics of patients initiating dapagliflozin treatmentin routine clinical care and assesses subsequent changes in HbA1c andbody weight.Materials andmethods: This retrospective observational study was conductedusing the Clinical Practice Research Datalink which contains recordsfrom 684 primary care practices in the UK. The study cohortconsisted of patients with T2DM given a first prescription fordapagliflozin between Nov 2012 and Sept 2014 who were registered≥6 months prior to that prescription and remained registered for≥3 months after dapagliflozin initiation. Changes in HbA1c and weightwere reported for patients with a measure pre-initiation and at least onemeasure during dapagliflozin treatment (up to 12 months follow-up).Results: Of 2401 patients with ≥1 prescription for dapagliflozin, 1732fulfilled the inclusion criteria. Mean age was 57.5 (SD:10.5) years,weightwas 103.1(SD:23.0) kg, HbA1c was 80.1(SD:17.9) mmol/mol and timesince T2DM diagnosis was 9.5 (SD:6.0) years: 58% of patients weremale. A history of retinopathy was present in 36.9%, nephropathy in9.8% and neuropathy in 20.4%. The most common usages ofdapagliflozin treatment were dual therapy with metformin (435, 25%),triple therapy (480, 28%) and add-on to insulin (332, 19%). 1091 patientshad HbA1c values and 970 had weight recorded before initiation ofdapagliflozin and on treatment. Reductions in HbA1c and weight wereobserved with each of the more common treatment combinations andoverall (see table). A greater reduction was observed in patients withhigher baseline HbA1c (upper tertile, 17.8 (15.4-20.1) mmol/mol) comparedto those with a lower baseline (lower tertile, 2.6 (1.3-3.2)mmol/mol) as measured 14-90 days post-initiation.Conclusion: Reductions in HbA1c and weight observed in a routinelytreated UK T2DM population were consistent with results from thedapagliflozin clinical trial program. Reductions were observed withdapagliflozin in combination with metformin, two glucose-loweringagents and insulin.
Original languageEnglish
Article number737
Pages (from-to)S352-S356
Number of pages2
JournalDiabetologia
Volume58
Issue numberSuppl.1
Early online date12 Aug 2015
DOIs
Publication statusPublished - Sep 2015
Event51st EASD Annual Meeting - Stockholm, Sweden
Duration: 14 Sep 201518 Sep 2015

Bibliographical note

Abstracts of the 51st EASD Annual Meeting, Stockholm, Sweden, 14–18 September 2015

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