Evaluating Cardio-Protective Molecules by Efficacy Based on Weight Reduction and HbA1c Targets

Area of Science:

• Endocrinology
• Pharmacology
• Metabolic Diseases

Background:

• Type 2 diabetes mellitus (T2DM) management often involves multiple therapeutic strategies.
• Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT-2i) are key drug classes for T2DM.
• Evaluating their comparative effectiveness on glycemic control and body weight is crucial.

Purpose of the Study:

• To compare the efficacy of GLP-1 RAs and SGLT-2i in T2DM patients.
• To assess achievement of HbA1c <7% and body weight reduction (BWR) of 5%.
• To evaluate treatment response over 12 months in a real-world setting.

Main Methods:

• Retrospective analysis of 405 out-patients with T2DM in Romania.
• Data collected at baseline, 6 months, and 12 months.
• Comparison of metformin, GLP-1 RAs, and SGLT-2i based on combined endpoint achievement.

Main Results:

• SGLT-2i achieved significantly higher combined endpoint rates (22.7% at 12 months, p < 0.001) compared to GLP-1 RAs and metformin.
• HbA1c reduction and BWR were more consistent with SGLT-2i over 12 months.
• While initial HbA1c targets were met by many, BWR was less consistent, potentially influenced by insulin use.

Conclusions:

• SGLT-2i demonstrated superior real-world efficacy in T2DM patients compared to metformin and GLP-1 RAs.
• SGLT-2i facilitate achieving both glycemic control (HbA1c <7%) and body weight reduction (5%).
• This highlights the significant role of SGLT-2i in modern T2DM management.