Subject    :    [2019 Apr;43(2)] Predictors of the Therapeutic Efficacy and Consideration of the Best Combination Therapy of Sodium-Glucose Co-transporter 2 Inhibitors
Writer KDA
Date 2019-04-18 10:29:51 Hit 1,366
LINK URL https://e-dmj.org/search.php?where=aview&id=10.4093/dmj.2018.0057&code=2004DMJ&vmode=FULL (Click 25)
Diabetes Metab J. 2019 Apr;43(2):158-173. English.
Published online Jan 25, 2019.  https://doi.org/10.4093/dmj.2018.0057 
Copyright © 2019 Korean Diabetes Association
   
Predictors of the Therapeutic Efficacy and Consideration of the Best Combination Therapy of Sodium-Glucose Co-transporter 2 Inhibitors
Ji-Yeon Lee,1 Yongin Cho,1 Minyoung Lee,1 You Jin Kim,1,2 Yong-ho Lee,1,3 Byung-Wan Lee,1,3 Bong-Soo Cha,1,3 and Eun Seok Kang1,3
1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
2Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea.
3Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea.

Corresponding author: Eun Seok Kang. Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Email: edgo@yuhs.ac 
 
Received April 05, 2018; Accepted October 04, 2018.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

 
Abstract

Background

We investigated the predictive markers for the therapeutic efficacy and the best combination of sodium-glucose co-transporter 2 (SGLT2) inhibitors (empagliflozin, dapagliflozin, and ipragliflozin) therapy in patients with type 2 diabetes mellitus (T2DM).

Methods

A total of 804 patients with T2DM who had taken SGLT2 inhibitor as monotherapy or an add-on therapy were analyzed. Multivariate regression analyses were performed to identify the predictors of SGLT2 inhibitor response including the classes of baseline anti-diabetic medications.

Results

After adjusting for age, sex, baseline body mass index (BMI), diabetes duration, duration of SGLT2 inhibitor use, initial glycosylated hemoglobin (HbA1c) level, estimated glomerular filtration rate (eGFR), and other anti-diabetic agent usage, multivariate analysis revealed that shorter diabetes duration, higher initial HbA1c and eGFR were associated with better glycemic response. However, baseline BMI was inversely correlated with glycemic status; lean subjects with well-controlled diabetes and obese subjects with inadequately controlled diabetes received more benefit from SGLT2 inhibitor treatment. In addition, dipeptidyl peptidase 4 (DPP4) inhibitor use was related to a greater reduction in HbA1c in patients with higher baseline HbA1c ≥7%. Sulfonylurea users experienced a larger change from baseline HbA1c but the significance was lost after adjustment for covariates and metformin and thiazolidinedione use did not affect the glycemic outcome.

Conclusion

A better response to SGLT2 inhibitors is expected in Korean T2DM patients who have higher baseline HbA1c and eGFR with a shorter diabetes duration. Moreover, the add-on of an SGLT2 inhibitor to a DPP4 inhibitor is likely to show the greatest glycemic response.

   
Keywords:
Blood glucoseDiabetes mellitus, type 2Glycated hemoglobin ASodium-glucose transporter 2 inhibitors

Articles - Reviews in DMJ
No. Subject Date Hit ↓
Notice : [2019 June;43(3)] Serum R-Spondin 1 Is a New Surrogate Marker for Obesity and Insulin Resistance [2019 June;43(3)] Serum R-Spondin 1 Is a New Surrogate Marker for Ob... 2019-06-28 837
Notice : [2019 June;43(3)] Association of Visit-to-Visit Variability of Blood Pressure with Cardiovascular Disease among Type 2 Diabetes Mellitus Patients: A Cohort Study [2019 June;43(3)] Association of Visit-to-Visit Variability of Blood... 2019-06-28 1,008
Notice : [2019 June;43(3)]  Oral Glucose Tolerance Testing Allows Better Prediction of Diabetes in Women with a History of Gestational Diabetes Mellitus [2019 June;43(3)] Oral Glucose Tolerance Testing Allows Better Pred... 2019-06-28 846
Notice : [2019 June;43(3)] Diabetes Mellitus and Cause-Specific Mortality: A Population-Based Study [2019 June;43(3)] Diabetes Mellitus and Cause-Specific Mortality: A ... 2019-06-28 846
Notice : [2019 June;43(3)]  Effectiveness of Exercise Intervention in Reducing Body Weight and Glycosylated Hemoglobin Levels in Patients with Type 2 Diabetes Mellitus in Korea: A Systematic Review and Meta-Analysis [2019 June;43(3)] Effectiveness of Exercise Intervention in Reducin... 2019-06-28 814
Notice : [2019 June;43(3)] Acarbose Add-on Therapy in Patients with Type 2 Diabetes Mellitus with Metformin and Sitagliptin Failure: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Study [2019 June;43(3)] Acarbose Add-on Therapy in Patients with Type 2 Di... 2019-06-28 1,235
Notice : [2019 June;43(3)] Efficacy and Safety of Voglibose Plus Metformin in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial [2019 June;43(3)] Efficacy and Safety of Voglibose Plus Metformin in... 2019-06-28 820
Notice : [2019 June;43(3)] Understanding Bile Acid Signaling in Diabetes: From Pathophysiology to Therapeutic Targets [2019 June;43(3)] Understanding Bile Acid Signaling in Diabetes: Fro... 2019-06-28 804
Notice : [2019 June;43(3)] Mitochondrial Dysfunction in Adipocytes as a Primary Cause of Adipose Tissue Inflammation [2019 June;43(3)] Mitochondrial Dysfunction in Adipocytes as a Prima... 2019-06-18 1,071
292 [2019 Apr;43(2)] Associations between Breastfeeding and Type 2 Diabe... 2019-04-18 1,689
291 [2019 Apr;43(2)] Increased Nociceptive Responses in Streptozotocin-I... 2019-04-18 1,370
290 [2019 Apr;43(2)] The Risk of Myocardial Infarction and Ischemic Stro... 2019-04-18 1,461
289 [2019 Apr;43(2)] Myricetin Protects Against High Glucose-Induced ... 2019-04-18 1,419
288 [2019 Apr;43(2)] Association between Changes in Anthropometric Indic... 2019-04-18 1,375
287 [2019 Apr;43(2)] Discrepancies between Glycosylated Hemoglobin and F... 2019-04-18 1,386
286 [2019 Apr;43(2)] Predictors of the Therapeutic Efficacy and Consider... 2019-04-18 1,366
285 [2019 Apr;43(2)] Metabolic Consequences of Obstructive Sleep Apnea E... 2019-04-18 1,393
284 [2019 Apr;43(2)] Nonalcoholic Fatty Liver Disease and Diabetes: Part... 2019-04-18 1,379
283 [2019 Feb;43(1)] Higher High Density Lipoprotein 2 (HDL2) to Total H... 2019-03-06 280

목록

Gets the previous 5 pages.   Go to previous page.  [1]   2   3   4   5     Go to next page. Gets the next  5 pages.