Dapagliflozin, as Add-on Therapy in Type 2 Diabetes Patients, Is Associated With a Reduction in Albuminuria and Serum Transaminase Levels

Benjamin, Silas and Ramanjaneya, Manjunath and Butler, Alexandra E. and Janjua, Imran and Paramba, Firjeeth and Palaki, Jafer and Kubaisi, Aisha Al and Chandra, Prem and Abdalhakam, Ibrahem and Massodi, Nasseer Ahmad (2021) Dapagliflozin, as Add-on Therapy in Type 2 Diabetes Patients, Is Associated With a Reduction in Albuminuria and Serum Transaminase Levels. Frontiers in Clinical Diabetes and Healthcare, 2. ISSN 2673-6616

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Abstract

Introduction: SGLT-2 inhibitors are shown to be nephroprotective, slowing progression of nonalcoholic steatohepatitis (NASH) in addition to improving glycemic control in patients with type 2 diabetes (T2D). To date, no real-life clinical data is available on the effect of SGLT-2 inhibitors on urine albumin-creatinine ratio (ACR) and liver enzymes in a Middle Eastern population. Therefore, we evaluated the effect of dapagliflozin (DAPA) on urine ACR, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) when added to standard therapy for T2D.

Methods: This is an observational study of 40 patients with T2D in whom DAPA was added to their existing anti-diabetic regimen to improve glycemic control. The primary outcomes were changes in serum transaminase level and urine albumin-to-creatinine ratio (ACR). Secondary outcomes include changes in glycosylated hemoglobin (HbA1C), body mass index (BMI), oral hypoglycemic agents and insulin dose.

Results: Whole group analysis showed a reduction in ALT (p<0.0001), (AST) (p=0.009), ACR (p=0.009) and BMI (p<0.0001) following DAPA treatment. Further sub-group analysis showed that patients on insulin and DAPA combination had a reduction in ACR (p=0.0090), ALT (p=0.0312), BMI (p=0.0007) and HbA1c (p<0.0001) compared to the sulfonylurea and DAPA combination group. In the sulfonylurea and DAPA combination group, there was a reduction in the sulfonylurea requirement following DAPA therapy (p=0.0116), with reductions in ALT (p=0.0122), AST (p=0.0362), BMI (p=0.0026) and HbA1c (p<0.0001) but with no change in ACR (p=0.814).

Conclusion: In routine clinical practice, the addition of DAPA to standard medical therapy is well tolerated and beneficial for T2D patients and is associated with a reduction of ALT and ACR.

Item Type: Article
Subjects: Opene Prints > Medical Science
Depositing User: Managing Editor
Date Deposited: 22 Nov 2022 05:45
Last Modified: 01 Jul 2024 06:23
URI: http://geographical.go2journals.com/id/eprint/254

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