SGLT2 inhibitors show benefits as add on treatment but HbA1c targets remain a challenge

Benedict Jephcote
Wed, 02 Aug 2017
SGLT2 inhibitors show benefits as add on treatment but HbA1c targets remain a challenge
Real-world data from a new research study has shown that SGLT2 inhibitor drugs are beneficial as an add-on treatment for people with type 2 diabetes on insulin but could not achieve all aims.

Intensive insulin therapy commonly leads to weight gain and hypoglycemia and is not always effective in achieving a low enough HbA1c.

Whilst there are randomised clinical trials into the effects of SGLT2 inhibitors, the researchers noted that there is little in the way of trials evaluating the effects of them in the real world.

As a result, the researchers were keen to investigate the real-world data themselves. To do so, they used health data from patients with type 2 diabetes in North America.

411 patients met the criteria required for the study. The criteria included being on insulin with an HbA1c of over 53 mmol/mol (7%) before starting on either dapagliflozin (sold as Farxiga in the US and Forxiga in the UK) or canagliflozin (sold as Invokana) in addition to the insulin.

The results showed that both drugs achieved a significant reduction in HbA1c levels, body weight, blood pressure and insulin doses. However, the number of people able to achieve the target HbA1c of 53 mmol/mol or under was still a small percentage.

The way the research was run did not enable the researchers to know how many hypos people were having before or after starting SGLT2 inhibitor medication.

The research, published in the Diabetes Care journal, shows that SGLT2 inhibitors have a number of key benefits but may not lead to optimal blood glucose control in most patients that are at a stage whereby they need insulin.

Whilst the researchers were not able to access data relating dietary habits, it is likely that diet is likely to be a significant reason why people were unable to meet HbA1c targets.

Medications, such as insulin and SGLT2 inhibitors, can be helpful to an extent but a healthy lifestyle is the backbone of great diabetes control.

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