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Comparative Effectiveness of Oral Hypoglycemic Agents for Glycemic Control and Glycemic Variability in Patients with

Poongothai Venkatachalapathy1, Karthik Kumar Dos Alagarswamy Mohandoss2, Murali Munisamy1,3

  • 1Department of Pharmacy Practice, Karpagam College of Pharmacy, Coimbatore, Tamil Nadu, India.

Current Diabetes Reviews
|February 4, 2024
PubMed
Abstract

Insights

Sodium-glucose co-transporter-2 (SGLT2) inhibitor monotherapy in type 2 diabetes patients significantly improved glycemic control and reduced glycemic variability. Optimal glycemic control correlates with decreased glycemic variability.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Pharmacology

Background:

  • Traditional diabetes management relies on HbA1c, but glycemic variability is an emerging target for preventing complications.
  • Flash Glucose Monitoring (FGM) offers continuous data for assessing glycemic control and variability.

Purpose of the Study:

  • To compare the effectiveness of oral hypoglycemic agents (OHAs) monotherapy, dual, and quadruple therapy for glycemic control (GC) and glycemic variability (GV) in type 2 diabetes (T2DM) patients.
  • To analyze relationships between GC and GV indices using FGM data.

Main Methods:

  • Retrospective analysis of FGM data from 50 T2DM patients.
  • Patients categorized into monotherapy (DPP-4 inhibitors, SGLT2 inhibitors, Sulphonylureas), dual therapy, and quadruple therapy groups.
  • Evaluation of GC (eA1c, MBG, TIR) and GV (SD, CV, MAGE, MODD) measures.

Main Results:

  • SGLT2 inhibitor monotherapy group showed optimal GC (eA1c: 6.5 ± 2.2) and GV (MAGE: 96.76 ± 52.47).
  • Significant differences in GC and GV measurements were observed across study groups.
  • Pearson correlation revealed a moderate correlation (r=0.742) between mean blood glucose (MBG) and mean amplitude of glycemic excursion (MAGE).

Conclusions:

  • SGLT2 inhibitor monotherapy effectively lowers glucose and reduces glycemic variability in T2DM.
  • Achieving optimal glycemic control is linked to decreased glycemic variability.
Keywords:
Glycemic controlambulatory glucose profile.flash glucose monitoringglycemic variabilityoral hypoglycemic agentstype 2 diabetes mellitus

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