Diabetes, Metabolic Syndrome and Obesity (Nov 2022)
Efficacy of Dapagliflozin in Southern Europe Across the Spectrum of Characteristics of Type 2 Diabetes: An International Real-World Analysis
Abstract
Gian Paolo Fadini,1 Cristobal Morales,2 Irene Caballero,2 Beatriz González,2 Nikolaos Tentolouris,3 Agostino Consoli4 1Division of Metabolic Diseases, Department of Medicine, University of Padova, Padua, Italy; 2Hospital Virgen Macarena (Sevilla); Hospital Vithas (Sevilla), Sevilla, Spain; 3Diabetes Centre, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece; 4Department of Medicine and Aging Sciences (DMSI) and Center of Advanced Studies and Technologies (CAST), University of Chieti, Chieti, ItalyCorrespondence: Gian Paolo Fadini, Department of Medicine, University of Padova, Via Giustiniani 2, Padova, 35128, Italy, Tel +39 049 8214318, Email [email protected]: To extend a prior real-world analysis (DARWIN-T2D) of patients with type 2 diabetes initiating dapagliflozin in Italy, Greece, and Spain by evaluating changes in glycemic and extra-glycemic endpoints after initiation of dapagliflozin.Patients and Methods: The association among demographic/clinical characteristics and the change in glycemic and extraglycemic effectiveness endpoints during the observation period was assayed using a mixed effects model.Results: A total of 1438 (860 males; 59.8%) patients were evaluated; patients were followed for a mean of 5.6 months. At baseline, 93.4% and 61.9% of patients were on concomitant metformin and insulin, respectively. A significant mean decrease in HbA1c from 8.7% to 7.5% was observed. The mixed model used also revealed several associations between different glycemic and laboratory parameters and patient characteristics at baseline; insulin use was significantly associated with lower HbA1c. Patients with BMI ≥ 30 kg/m2 experienced greater weight loss than those with BMI < 30 kg/m2. A consistent glucose-lowering effect of dapagliflozin was seen in all subgroups of patients, including those with stage 2 renal impairment and cardiovascular disease.Conclusion: The present analysis confirms the efficacy of dapagliflozin in diversified real-world settings with broadly similar effects on HbA1c across countries and baseline characteristics.Keywords: type 2 diabetes, dapagliflozin, real-life, glycemic control
