Dapagliflozin in Type 2 Diabetes Patients in Routine Internal Medicine and Endocrinology Outpatient Clinical Care; A Retrospective Cohort Study from Turkey

Abstract

Background and Aims: The present study aimed to describe characteristics of patients with type 2 diabetes (T2D) initiated on dapagliflozin in routine outpatient clinical care in Turkey, post-dapagliflozin changes in glycated hemoglobin (HbA1c), body weight and blood pressure. Materials and Methods: Descriptive retrospective observational cohort study using data from Turkish patient medical records from 79 different internal medicine or endocrinology clinics. Study cohort will include T2D patients who received at least one prescription for dapagliflozin for the first time between July 2016 and June 2017 and who have been registered in that centre for at least 6 months prior to the first dapagliflozin prescription. Results: In total, 1683 patients were identified. The mean age of the patients (56.6% female) included in the analysis was 54.9 years (Table 1). At baseline, mean HbA1c was 9.1% and the mean weight was 89.2 kg. The mean time since T2D diagnosis was 9.1 years and 26.4% of patients had a history of retinopathy, 11.3% a history of neuropathy and 8.3% a history of nephropathy. HbA1c values were recorded in 815 patients, body weight was recorded in 851 and blood pressure in 799 patients before the first prescription of dapagliflozin and during dapagliflozin treatment, 6 months after starting dapagliflozin. HbA1c declined by mean of-1.33% (95% CI-1.44 to-1.20, p<0.001), weight declined by mean of-4.18 kg (95% CI-4.65 to 3.71, p<0.001), and systolic and diastolic blood pressure decreased by means of-8.68 (95% CI-9.53 to-7.83, p<0.001) and-4.92 (95% CI-5.54 to-4.29, p<0.001) mmHg, respectively from baseline (Table 2). Results were consistent across subgroups. Conclusion: This real world evidence study showed significant and clinically meaningful reductions in HbA1c, body weight and blood pressure after initiation of dapagliflozin in patients with T2D in Turkey, and these results support changes observed with dapagliflozin treatment in randomized clinical trials.