Clinical outcomes of Sodium-glucose cotransporter-2 inhibitors in patients with Type 2 Diabetes Mellitus: An observational study from Pakistan

Abstract

Objective: To determine the efficacy and safety of Sodium-glucose cotransporter-2 inhibitors (SGLT2i) use in the Pakistani population.
 Methods: Retrospective review of initial 100 patients who were prescribed with any agent of the SGLT2i group from July 1, 2018 to January 2019 at Aga Khan University Hospital, Karachi. SGLT2i was offered to patients of above 18 years of age with inadequate glycemic control on existing antidiabetic agents. Changes in HbA1c, the Body Mass Index (BMI), serum creatinine, any decrease in the requirement of insulin and sulphonylurea dose along with any side effects reported by the patients on follow-up visits.
 Results: Most study participants were females (56%) with the mean age of 52±10 years. Substantial changes were observed in the HbA1c (7.5±1.1%, 7.9±1.2% from 8.7±1.5%, p < 0.01), BMI (31.4±5.8, 31.8±5.8 from 32.4±5.9kg/m2, p < 0.01) and in creatinine (0.71±0.1, 0.75±0.1 from 0.79±0.1 mg/dl, p < 0.01) at three and six months of follow up visits. The reduction in insulin and sulphonylurea doses was also significant. Adverse drug events that led to drug discontinuation in 14 individuals were, Urinary tract infection (UTI) (seven patients), Genital infection (three patients), nausea +UTI, abdominal pain +UTI, mild Diabetic Ketoacidosis, and polyuria (one patient each). None reported Fournier’s gangrene, limb amputation, or fracture.
 Conclusion: SGLT2i significantly improved glycemic control, BMI, and serum creatinine in the Pakistani population with a very low number of observed adverse events.
 doi: https://doi.org/10.12669/pjms.37.5.3901
 How to cite this:Das B, Sheikh A, Ahmed B, Islam N. Clinical outcomes of Sodium-glucose cotransporter-2 inhibitors in patients with Type 2 Diabetes Mellitus: An observational study from Pakistan. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.3901
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Urinary Tract Infection (Uti) in Postmenopausal Women With Type 2 Diabetes Mellitus Using Sodium Glucose Co Transporter 2 Inhibitors (Sglt-2 I)

“…We did not specifically study the job, but those whose monthly income was less than Rs.35, 000 had an increased incidence of urinary tract infection. Another study conducted in South Korea showed that sodium-glucose co-transporter 2 inhibitors significantly increased the risk of urinary tract infection in type 2 diabetes mellitus patients when used as an add-on therapy to metformin as compared to sulfonylureas, DPP4 inhibitors, and thiazolidindione 16 .…”

Safety of sodium-glucose cotransporter 2 inhibitors (SGLT2i) during the month of Ramadan in patients with type 2 diabetes mellitus in Pakistani population—an observational study from a tertiary care center in Karachi

“…The antidiabetic treatments, along with the complications of Diabetes and comorbid conditions, thus make the management of diabetes during Ramadan fasting quite challenging for the treating physicians [16]. SGLT2i is a relatively newer group of anti-diabetic agents that are efficacious with a reasonable safety profile and have shown promising results in terms of cardiac and renal benefits [17][18][19][20][21], hence physicians would want to continue with this group of drugs during Ramadan fasting as well. At the same time because of the diuretic effects and reported cases of diabetic acidosis, dehydration, and volume depletion [22,23], there are theoretical concerns regarding the safety of SGLT2i during Ramadan fasting especially during summer when fasting hours are long.…”

Safety of sodium-glucose cotransporter 2 inhibitors (SGLT2i) during the month of Ramadan in patients with Type 2 Diabetes Mellitus in Pakistani population -an observational study from a tertiary care center in Karachi

“…SGLT2i is a relatively newer group of anti-diabetic agents that are e cacious with a reasonable safety pro le and have shown promising results in terms of cardiac and renal bene ts [17][18][19][20][21], hence physicians must want to continue with this group of drugs during Ramadan fasting as well. At the same time because of the diuretic effects and reported cases of diabetic acidosis, dehydration, and volume depletion [22,23], there are theoretical concerns regarding the safety of SGLT2i during Ramadan fasting especially during summer and long fasting hours.…”