SGLT2 inhibitors in the treatment of diabetes and weight influence, the experience of a Portuguese primary care unit

Authors

  • Cátia Vasconcelos USF Terras do Ave. Delães, Portugal.
  • Susana Vilar Santos USF Terras do Ave. Delães, Portugal.
  • António Vilela USF Terras do Ave. Delães, Portugal.
  • Rita de Faria USF Terras do Ave. Delães, Portugal.
  • Álvaro Reis USF Terras do Ave. Delães, Portugal.

DOI:

https://doi.org/10.32385/rpmgf.v39i3.13641

Keywords:

Diabetes mellitus, Sodium-glucose transporter 2 inhibitors, Body weight, Primary care

Abstract

Introduction: Weight loss in diabetic patients can be associated with cardiovascular risk reduction. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) have beneficial effects in the reduction of cardiovascular risk and are approved for the treatment of diabetes. Additionally, iSGLT2 is associated with a weight loss of approximately 2 kg in the first six months of treatment. In this study, we report the experience of a Portuguese primary care unit with this class and evaluate the effects on weight, waist circumference, and glycemic control during 12 months of follow-up.

Methods: This is an observational retrospective study. Patients with diabetes under treatment with SGLT2i who completed 12 months of follow-up were included. The exclusion criteria included: therapeutic changes and medical or surgical complications. The patients were evaluated at zero, six, and 12 months after the SGLT2i institution. The variables analyzed included weight, waist circumference, and glycated hemoglobin.

Results: One hundred and eighty-seven patients were included. The mean age was 65 ± 10.4 years old, and the majority was male (62.0%). The average duration of diabetes was 9 ± 7.4 years. Most patients were under therapy with dapagliflozin (65.8%) and the rest with empagliflozin (34.2%). Weight loss was significant between zero- and six-month follow-up (p<0.001) and between six and 12 months (p=0.01), with reductions of 2.3 ± 0.2kg and 0.5 ± 0.2kg respectively. Waist circumference and glycated hemoglobin reduced significantly from zero to six months, 1.5 ± 0.3cm (p<0.001) and 0.9 ± 0.8% (p<0.001), respectively. Both variables had no significant changes between six and 12-month follow-ups.

Conclusion: The use of iSGLT2 in the treatment of patients with diabetes in a real-life study showed significant improvement in glycemic control, weight loss, and waist circumference.

Downloads

Download data is not yet available.

References

Sohail E, Ahsan T, Ghaus S, Aijaz W. SGLT 2 inhibitors, glycemic control, weight loss and safety profile in patients with type 2 diabetes, at Medicell Institute (MIDEM). Pak J Med Sci. 2021;37(1):87-92.

Raposo JF. Diabetes: factos e números 2016, 2017 e 2018. Rev Port Diabetes. 2020;15(1):19-27.

Silva-Nunes J, Aguiar C, Birne R, Branco P, Calado J, Matos P, et al. Empagliflozina e a nova era no tratamento da diabetes tipo 2: para além do controlo glicémico [Empagliflozin and the new age in the treatment of type 2 diabetes: beyond glycemic control]. Rev Port Diabetes. 2017;12(1):9-22. Portuguese

Thewjitcharoen Y, Yenseung N, Malidaeng A, Nakasatien S, Chotwanvirat P, Krittiyawong S, et al. Effectiveness of long-term treatment with SGLT2 inhibitors: real-world evidence from a specialized diabetes center. Diabetol Metab Syndr. 2017;9:96.

Monteiro P, Aguiar C, Matos P, Silva‐Nunes J, Birne R, Branco P, et al. Effect of empagliflozin beyond glycemic control: cardiovascular benefit in patients with type 2 diabetes and established cardiovascular disease. Rev Port Cardiol. 2019;38(10):721-35.

Lazzaroni E, Nasr MB, Loretelli C, Pastore I, Plebani L, Lunati ME, et al. Anti-diabetic drugs and weight loss in patients with type 2 diabetes. Pharmacol Res. 2021;171:105782.

Pereira MJ, Eriksson JW. Emerging role of SGLT-2 inhibitors for the treatment of obesity. Drugs. 2019;79(3):219-30.

Apovian CM, Okemah J, O’Neil PM. Body weight considerations in the management of type 2 diabetes. Adv Ther. 2019;36(1):44-58.

Janež A, Fioretto P. SGLT2 inhibitors and the clinical implications of associated weight loss in type 2 diabetes: a narrative review. Diabetes Ther. 2021;12(8):2249-61.

Bolinder J, Ljunggren Ö, Kullberg J, Johansson L, Wilding J, Langkilde AM, et al. Effects of dapagliflozin on body weight, total fat mass, and regional adipose tissue distribution in patients with type 2 diabetes mellitus with inadequate glycemic control on metformin. J Clin Endocrinol Metab. 2012;97(3):1020-31.

Ribola FA, Cançado FB, Schoueri JH, De Toni VF, Medeiros VH, Feder D. Effects of SGLT2 inhibitors on weight loss in patients with type 2 diabetes mellitus. Eur Rev Med Pharmacol Sci. 2017;21(1):199-211.

Feder D, Gouveia MR, Govato TC, Nassis CZ. SGLT2 Inhibitors and the mechanisms involved in weight loss. Curr Pharmacol Rep. 2020;6:346-53.

Zaccardi F, Webb DR, Htike ZZ, Youssef D, Khunti K, Davies MJ. Efficacy and safety of sodium-glucose co-transporter-2 inhibitors in type 2 diabetes mellitus: systematic review and network meta-analysis. Diabetes Obes Metab. 2016;18(8):783-94.

Sasaki T, Sugawara M, Fukuda M. Sodium-glucose cotransporter 2 inhibitor-induced changes in body composition and simultaneous changes in metabolic profile: 52-week prospective LIGHT (Luseogliflozin: the components of weight loss in Japanese patients with type 2 diabetes mellitus) study. J Diabetes Investig. 2019;10(1):108-17.

Saisho Y. SGLT2 inhibitors: the star in the treatment of type 2 diabetes? Diseases. 2020;8(2):14.

Mearns ES, Sobieraj DM, White CM, Saulsberry WJ, Kohn CG, Doleh Y, et al. Comparative efficacy and safety of antidiabetic drug regimens added to metformin monotherapy in patients with type 2 diabetes: a network meta-analysis. PLoS One. 2015;10(4):e0125879.

Schork A, Saynisch J, Vosseler A, Jaghutriz BA, Heyne N, Peter A, et al. Effect of SGLT2 inhibitors on body composition, fluid status and renin–angiotensin–aldosterone system in type 2 diabetes: a prospective study using bioimpedance spectroscopy. Cardiovasc Diabetol. 2019;18(1):46.

Ferrannini G, Hach T, Crowe S, Sanghvi A, Hall KD, Ferrannini E. Energy balance after sodium-glucose cotransporter 2 inhibition. Diabetes Care. 2015;38(9):1730-5.

Klein S, Allison DB, Heymsfield SB, Kelley DE, Leibel RL, Nonas C,et al. Waist circumference and cardiometabolic risk: a consensus statement from shaping America's health: Association for Weight Management and Obesity Prevention; NAASO, the Obesity Society; the American Society for Nutrition; and the American Diabetes Association. Diabetes Care. 2007;30(6):1647-52.

Li J, Gong Y, Li C, Lu Y, Liu Y, Shao Y. Long-term efficacy and safety of sodium-glucose cotransporter-2 inhibitors as add-on to metformin treatment in the management of type 2 diabetes mellitus: a meta-analysis. Medicine. 2017;96(27):e7201.

Neeland IJ, McGuire DK, Chilton R, Crowe S, Lund SS, Woerle HJ, et al. Empagliflozin reduces body weight and indices of adipose distribution in patients with type 2 diabetes mellitus. Diab Vasc Dis Res. 2016;13(2):119-26.

Published

2023-07-05

How to Cite

SGLT2 inhibitors in the treatment of diabetes and weight influence, the experience of a Portuguese primary care unit. (2023). Portuguese Journal of Family Medicine and General Practice, 39(3), 187-94. https://doi.org/10.32385/rpmgf.v39i3.13641

Most read articles by the same author(s)