Real-world evaluation of Hba1c, blood pressure, and weight loss among patients with type 2 diabetes mellitus treated with canagliflozin: an analysis of electronic medical records from a network of hospitals in Florida

Tanton, Damon; Duh, Mei Sheng; Lafeuille, Marie-Hélène; Lefèbvre, Patrick; Pilon, Dominic; Zhdanava, Maryia; Émond, Bruno; Inman, Doreen; Bailey, Robert A.

doi:10.1080/03007995.2018.1444591

Cited by 5 publications

(6 citation statements)

References 37 publications

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“…The overall baseline-adjusted HbA1c reduction at 6 months (1.1%) is similar to HbA1c control reported in the meta-analysis of 38 clinical trials, 39 the recent clinical trial in 150 black patients receiving empagliflozin, 40 the US EMR-based study in 886 white and 155 black patients, 27 but lower than the average HbA1c reduction of 2.48% reported in the systematic review reported by Mazidi et al 16 However, our 6-month analysis is based on on-therapy patients, and was not an intention-to-treat analysis, and hence cannot be generalized in a real-world scenario.…”

Section: Discussionsupporting

confidence: 63%

“…38 The distributions of HbA1c, BMI and SBP in the present study were also similar to those reported in a study based on 1259 US patients treated with canagliflozin. 27 While the overall adjusted mean reduction in HbA1c at 6 months among those with HbA1c >58.5 mmol / mol% at baseline was similar in the two ethnic groups (1.1%), both ethnic groups had a mean HbA1c >63.9 mmol /mol over the 24 months after SGLT2 inhibitor initiation (similar for patients with and without ASCVD). However, black patients had a significantly higher HbA1c (on average above 69.4 mmol /mol%; Figures 1 and S2) with 33% less likelihood of achieving sustainable glycaemic control compared to white patients.…”

Section: Triglyceridesmentioning

confidence: 79%

“…This necessitates a comprehensive population‐level evaluation of cardiometabolic risk factor control in patients receiving SGLT2 inhibitors. While randomized controlled trials were not powered enough to assess ethnic differences, 21 only a few US studies have reported real‐world risk factor control with SGLT2 inhibitors, 26 and separately in a small number of white and black participants 27 . We are not aware of any population‐level study that holistically evaluated differences in cardiometabolic risk factor control or burden between white and black patients after initiation of SGLT2 inhibitors, with comprehensive assessment of patients with and without history of ASCVD.…”

Section: Introductionmentioning

confidence: 99%

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Cardiometabolic risk factor control in black and white people in the United States initiating sodium‐glucose co‐transporter‐2 inhibitors: A real‐world study

Montvida

Verma

Shaw

et al. 2020

Diabetes Obesity Metabolism

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Aims: To explore cardiometabolic risk profiles, the probability of sustainable control, and the effectiveness of treatment with sodium-glucose co-transporter-2 (SGLT2) inhibitors in black and white adults in the United States with type 2 diabetes. Materials and Methods: Using nationally representative US electronic medical records, 72 690 white and 10 004 black adults diagnosed with type 2 diabetes initiating SGLT2 inhibitors during the period 2013 to 2018, continuing it for ≥6 months, and with follow-up of ≥12 months, were identified. Glycated haemoglobin (HbA1c), body weight, systolic blood pressure (SBP) and lipid changes at 6 months, and sustainability of control over 18 months post SGLT2 inhibitor initiation were explored, separately in those with and without atherosclerotic cardiovascular disease (ASCVD). Results: The white group was older (58 years) with lower mean HbA1c (8.5%), compared to the black group (age 54 years, HbA1c 9.0%). Body mass index distribution was similar. The proportions of people with uncontrolled SBP, LDL cholesterol, non-HDL cholesterol and triglyceride levels were 24%, 42%, 51% and 62%, respectively, in white patients, and 31%, 51%, 49% and 32%, respectively, in black patients. At 6-month follow-up white and black patients had similar adjusted reductions in HbA1c (1.1%), SBP (8-10 mmHg), LDL cholesterol (0.26-0.34 mmol / L) and body weight (1.1-1.4 kg). However, over 18 months' follow-up, compared to white patients, black patients were significantly less likely to achieve sustainable control in HbA1c (odds ratio [OR] 0.67, 95% confidence interval [CI] 0.63-0.72), body weight (OR 0.81, 95% CI 0.72-0.91), SBP (OR 0.67, 95% CI 0.61-0.74) and LDL cholesterol (OR 0.77, 95% CI 0.67-0.89). Triglyceride control was significantly better among black patients. Black patients had a significantly higher risk factor burden, irrespective of ASCVD status. Conclusions: While the effectiveness of SGLT2 inhibitors was similar among black and white patients, irrespective of ASCVD status, black patients continued to have worse cardiometabolic risk factor burden after SGLT2 inhibitor initiation.

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Section: Discussionsupporting

confidence: 63%

Section: Triglyceridesmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cardiometabolic risk factor control in black and white people in the United States initiating sodium‐glucose co‐transporter‐2 inhibitors: A real‐world study

Montvida

Verma

Shaw

et al. 2020

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

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“…These publications contain detailed information on patient characteristics, prescription orders, laboratory results, adverse effects (AEs), and withdrawals (WDs). We have identified several of these studies with canagliflozin, most of which are retrospective [ 29 , 30 , 31 ], except the Canadian Canagliflozin Registry, which was a national prospective study [ 32 ]. In all these reports, real-life effectiveness with both doses of canagliflozin (100 and 300 mg) was similar to those seen in RCTs.…”

Section: Introductionmentioning

confidence: 99%

Real-World Clinical Outcomes Associated with Canagliflozin in Patients with Type 2 Diabetes Mellitus in Spain: The Real-Wecan Study

Gorgojo-Martínez

Gargallo-Fernández

Sanz-Pastor

et al. 2020

JCM

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The aims of this multicentric retrospective study were to assess in a real-world setting the effectiveness and safety of canagliflozin 100 mg/d (CANA100) as an add-on to the background antihyperglycemic therapy, and to evaluate the intensification of prior sodium–glucose co-transporter type 2 inhibitor (SGLT-2i) therapy by switching to canagliflozin 300 mg/d (CANA300) in patients with T2DM. One cohort of SGLT2i-naïve patients with T2DM who were initiated on CANA100 and a second cohort of patients with prior background SGLT-2i therapy who switched to CANA300 were included in the study. The primary outcome of the study was the mean change in HbA1c over the follow-up time. In total, 583 patients were included—279 in the cohort of CANA100 (HbA1c 8.05%, weight 94.9 kg) and 304 in the cohort of CANA300 (HbA1c 7.51%, weight 92.0 kg). Median follow-up periods in both cohorts were 9.1 and 15.4 months respectively. CANA100 was associated to significant reductions in HbA1c (−0.90%) and weight (−4.1 kg) at the end of the follow-up. In those patients with baseline HbA1c > 8% (mean 9.25%), CANA100 lowered HbA1c levels by 1.51%. In the second cohort, patients switching to CANA300 experienced a significant decrease in HbA1c (−0.35%) and weight (−2.1 kg). In those patients with baseline HbA1c > 8% (mean 8.94%), CANA300 lowered HbA1c levels by 1.12%. There were significant improvements in blood pressure in both cohorts. No unexpected adverse events were reported. In summary, CANA100 (as an add-on therapy) and CANA300 (switching from prior SGLT-2i therapy) significantly improved several cardiometabolic parameters in patients with T2DM.

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“…The development of DM is associated with lifestyle changes, environmental changes and healthy living behaviors [2,3]. Type-2 DM is a chronic condition characterized by hyperglycemia due to the progressive loss of β cell function and insulin resistance [4]. Indonesia's ranking of DM prevalence was the 5th in Asia Pacific [5].…”

Section: Introductionmentioning

confidence: 99%

Effects of dates (Phoenix Dactylifera Linn) on Blood Glucose Levels in Type-2 Diabetes Mellitus Patients

Wijayanti¹,

Pamungkasari²,

Sugiarto³

2019

Proceedings of the Proceedings of the 1st Seminar and Workshop on Research Design, for Education, Social Science, Arts, and Hum

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Type-2 diabetes mellitus (DM) burdens health care costs when complications occurred. Dates (Phoenix dactylifera Linn) contain almost complete nutrients, fiber and rich in antioxidants, which can control blood glucose levels. This study aimed to determine the effect of dates on blood glucose levels. This was the experimental study with Randomized Control Trial Pretest and Posttest. There were 36 outpatients of type-2 DM, divided into two groups, control and treatment. 50 grams of Lulu dates were given to the treatment group a day, while the control group were not. In 14 days, all groups were continued to consume oral anti-diabetic drugs. Daily intake data were obtained from 24-hr recall questionnaires, nutritional status data obtained from anthropometric measurements while data of DM from blood glucose levels. Data analysis using the Paired t-test. Results showed that the difference in the decrease of blood glucose levels, in control group (8.67 mg/dl, p-value=0.067) were lower than the treatment group (22.94 mg/dl, p-value=0.04). There were no significant decrease of blood glucose levels between control and treatment groups (p-value=0.223). In this study, consumption of dates has no significant effect on blood glucose levels, but further study are needed to know how dates can improve blood glucose levels.

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Real-world evaluation of Hba1c, blood pressure, and weight loss among patients with type 2 diabetes mellitus treated with canagliflozin: an analysis of electronic medical records from a network of hospitals in Florida

Abstract: In CANA-treated patients and patient sub-groups from a network of Florida hospitals, improvements in quality measures and response durability were similar to clinical trials and other real-world studies.

Cited by 5 publications

References 37 publications

Cardiometabolic risk factor control in black and white people in the United States initiating sodium‐glucose co‐transporter‐2 inhibitors: A real‐world study

Cardiometabolic risk factor control in black and white people in the United States initiating sodium‐glucose co‐transporter‐2 inhibitors: A real‐world study

Real-World Clinical Outcomes Associated with Canagliflozin in Patients with Type 2 Diabetes Mellitus in Spain: The Real-Wecan Study

Effects of dates (Phoenix Dactylifera Linn) on Blood Glucose Levels in Type-2 Diabetes Mellitus Patients

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