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Blood glucose levels and bodyweight change after dapagliflozin administration

Hyunah Kim1, Seung-Hwan Lee2,3, Hyunyong Lee4

  • 1College of Pharmacy, Sookmyung Women's University, Seoul, Korea.

Journal of Diabetes Investigation
|February 1, 2021
PubMed
Abstract

Insights

This study found that patients with higher baseline HbA1c levels prescribed dapagliflozin were more likely to experience weight gain than glucose changes. Physicians should consider lifestyle interventions for weight management in these patients.

Area of Science:

  • Endocrinology
  • Pharmacology
  • Metabolic Diseases

Background:

  • Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are commonly prescribed for diabetes management.
  • Patients on SGLT2i may experience variable changes in blood glucose and body weight.
  • Predicting individual patient responses to SGLT2i is crucial for optimizing treatment.

Purpose of the Study:

  • To identify predictors of blood glucose and weight changes in patients prescribed dapagliflozin.
  • To stratify patients based on their response to SGLT2i therapy using real-world data.

Main Methods:

  • Retrospective analysis of real-world data from patients prescribed dapagliflozin.
  • Patients categorized into four groups based on glucose and weight changes after 3 months: improved glucose/weight loss (H(+)W(+)), improved glucose/weight gain (H(+)W(-)), worsened glucose/weight loss (H(-)W(+)), and worsened glucose/weight gain (H(-)W(-)).
  • Statistical analysis to determine odds ratios for group allocation based on baseline HbA1c levels.

Main Results:

  • 53.5% of patients achieved improved glucose and weight loss (H(+)W(+)).
  • Higher baseline HbA1c levels significantly increased the odds of weight gain (H(+)W(-)) and worsened glucose control (H(-)W(+), H(-)W(-)) compared to H(+)W(+).
  • Odds of H(+)W(-) increased with higher baseline HbA1c (e.g., ≥9.0% showed 359% increased odds).

Conclusions:

  • Baseline HbA1c is a key factor in predicting dapagliflozin response, particularly regarding weight changes.
  • Physicians should anticipate potential weight gain over glucose improvement in patients with high baseline HbA1c.
  • Emphasis on lifestyle interventions, including diet and exercise, is recommended for weight management in SGLT2i users.
Keywords:
Hemoglobin A1cSodium-glucose cotransporter 2Weight

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