Factors that predict glycaemic response to sodium-glucose linked transporter (SGLT) inhibitors

Harding, AL; Bediaga, N; Galligan, A; Colman, PG; Fourlanos, S; Wentworth, JM

Author(s): Harding, AL; Bediaga, N; Galligan, A; Colman, PG; Fourlanos, S; Wentworth, JM;
Details: Publication Year 2021-04,Volume 51,Issue #4,Page 515-519
Journal Title: Internal Medicine Journal
Abstract: AIM: To determine the clinical and biochemical variables associated with change in HbA1c in patients with type 2 diabetes who start sodium-glucose linked transporter (SGLT) inhibitor therapy. METHODS: We performed a prospective cohort study (ACTRN12616000833460) of 48 adults (30 male, 18 female) with type 2 diabetes who attended a tertiary hospital diabetes clinic. Fasting serum and urine samples, collected during clinic visits prior to and at 1, 12 and 24 weeks after commencing SGLT inhibitor treatment, were analysed for HbA1c, electrolytes, urea, creatinine and glucose. RESULTS: After 12 weeks, SGLT inhibitor therapy was associated with respective median (97% CI) decreases in weight, blood pressure, HbA1c and urine albumin/creatinine ratio of 3.0 (1.7-3.4) kg, 8 (2-16)/4 (3-9) mmHg, 6 (3-14) mmol/mol and 0.69 (0.18-1.8) mg/mmol. These effects persisted to 24 weeks. Urinary frequency and genitourinary infection were common adverse effects. Baseline HbA1c and eGFR independently predicted DeltaHbA1c at 12 weeks whereas only baseline HbA1c independently predicted DeltaHbA1c at 24 weeks. Urinary fractional glucose excretion and change in fasting glucose 1 week after starting SGLT inhibitor did not contribute to prediction of glycaemic response. CONCLUSIONS: SGLT inhibitor therapy in a hospital clinic setting was associated with clinical improvements comparable to those observed in clinical trials but with higher incidence of genitourinary side-effects. Baseline HbA1c and eGFR, but not urine fractional glucose excretion, predicted glycaemic response.
Publisher: WIley
Keywords: type 2 diabetes, SGLT inhibitor, precision medicine, glycosuria, prospective clinical trial, biomarkers
Research Division(s): Population Health And Immunity
PubMed ID: 32092242
Publisher's Version: https://doi.org/10.1111/imj.14805
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2021-06-02 01:45:57

Last Modified: 2021-06-02 01:47:45