THE EFFICACY AND SAFETY OF DAPAGLIFLOZIN AND SITAGLIPTIN IN PATIENTS WITH UNCONTROLLED TYPE 2 DIABETES: A QUASI EXPERIMENTAL STUDY
DOI:
https://doi.org/10.54112/bcsrj.v2024i1.1372Keywords:
Dapagliflozin, Sitagliptin, Metformin, Uncontrolled diabetes type 2, HbA1cAbstract
Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder that requires effective glycemic control to prevent complications. Dapagliflozin, a sodium-glucose cotransporter-2 (SGLT2) inhibitor, and Sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, are commonly used in combination with Metformin for patients with uncontrolled T2DM. However, there is limited comparative data on the efficacy and safety of these two therapeutic regimens Objectives: To compare the efficacy and safety of Dapagliflozin and Sitagliptin in patients with uncontrolled type 2 diabetes. Methods: After approval from the ethical committee of Islamabad Medical Complex, 250 patients meeting the selection criteria were enrolled. Written informed consent was obtained from patients or their guardians. The patients were divided into two groups: Group A received Dapagliflozin with Metformin, while Group B received Sitagliptin with Metformin. Baseline lab tests were performed and repeated after 12 weeks, along with safety and tolerability assessments. Changes in HbA1c and other parameters were recorded. Efficacy was measured by changes in HbA1c, and safety was evaluated based on reported side effects. Data were collected using a predesigned questionnaire. Results: The study population had a mean age of 45.32 years and a mean BMI of 26.02; 54% were male and 46% female. Most participants (62.4%) were aged 31-50, and 33.2% were over 50. BMI distribution showed 45.6% were of normal weight, while 27.6% were obese. Group A's HbA1c dropped from 9.51 to 7.30 (mean difference: 2.20), and Group B's from 9.39 to 8.16 (mean difference: 1.23), both with p=0.00. Adverse effects included more UTIs in Group A (40.8% vs. 14.4%) and more diarrhea in Group B (38.4% vs. 4.8%), with small differences in other symptoms. Conclusion: The study concluded that both dapagliflozin and sitagliptin effectively reduce HbA1c in uncontrolled type 2 diabetes. Dapagliflozin showed a greater HbA1c reduction but had a higher rate of urinary tract infections, while sitagliptin had fewer UTIs but more gastrointestinal side effects. Further studies are needed to confirm these results and assess long-term safety and efficacy.
Downloads
References
Arokiasamy P, Salvi S, Selvamani Y. Global burden of diabetes mellitus. Handbook of global health: Springer; 2021. p. 1-44.
Mekala KC, Bertoni AG. Epidemiology of diabetes mellitus. Transplantation, bioengineering, and regeneration of the endocrine pancreas: Elsevier; 2020. p. 49-58.
Standl E, Khunti K, Hansen TB, Schnell O. The global epidemics of diabetes in the 21st century: Current situation and perspectives. European journal of preventive cardiology. 2019;26(2_suppl):7-14.
Kumar A, Bharti SK, Kumar A. Type 2 diabetes mellitus: the concerned complications and target organs. Apollo Medicine. 2014;11(3):161-6.
Ravikumar L, Kiwalkar RS, Ravindra H, Lokesh B, Dabhade D. Dapagliflozin and sitagliptin combination therapy: An overview of clinical utility in type 2 diabetes mellitus with multiple cardiovascular risk factors. Cardiology and Cardiovascular Medicine. 2023;7(2):141-4.
Thomas MC. Renal effects of dapagliflozin in patients with type 2 diabetes. Therapeutic advances in endocrinology and metabolism. 2014;5(3):53-61.
Sakura H, Hashimoto N, Sasamoto K, Ohashi H, Hasumi S, Ujihara N, et al. Effect of sitagliptin on blood glucose control in patients with type 2 diabetes mellitus who are treatment naive or poorly responsive to existing antidiabetic drugs: the JAMP study. BMC endocrine disorders. 2016;16:1-11.
Alam S, Hasan MK, Neaz S, Hussain N, Hossain MF, Rahman T. Diabetes Mellitus: insights from epidemiology, biochemistry, risk factors, diagnosis, complications and comprehensive management. Diabetology. 2021;2(2):36-50.
Osadebe PO, Odoh EU, Uzor PF. Oral anti-diabetic agents-review and updates. British Journal of Medicine and Medical Research. 2015;5(2):134-59.
Dai Z-C, Chen J-X, Zou R, Liang X-B, Tang J-X, Yao C-W. Role and mechanisms of SGLT-2 inhibitors in the treatment of diabetic kidney disease. Frontiers in Immunology. 2023;14:1213473.
Pratley RE, Salsali A. Inhibition of DPP-4: a new therapeutic approach for the treatment of type 2 diabetes. Current medical research and opinion. 2007;23(4):919-31.
Lamos EM, Hedrington M, Davis SN. An update on the safety and efficacy of oral antidiabetic drugs: DPP-4 inhibitors and SGLT-2 inhibitors. Expert opinion on drug safety. 2019;18(8):691-701.
Round EM, Engel SS, Golm GT, Davies MJ, Kaufman KD, Goldstein BJ. Safety of sitagliptin in elderly patients with type 2 diabetes: a pooled analysis of 25 clinical studies. Drugs & aging. 2014;31:203-14.
Bethel MA, Engel SS, Green JB, Huang Z, Josse RG, Kaufman KD, et al. Assessing the safety of sitagliptin in older participants in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS). Diabetes Care. 2017;40(4):494-501.
Cahn A, Mosenzon O, Wiviott SD, Rozenberg A, Yanuv I, Goodrich EL, et al. Efficacy and safety of dapagliflozin in the elderly: analysis from the DECLARE–TIMI 58 study. Diabetes care. 2020;43(2):468-75.
Anderson SL. Dapagliflozin efficacy and safety: a perspective review. Therapeutic advances in drug safety. 2014;5(6):242-54.
Wilding JP, Woo V, Soler NG, Pahor A, Sugg J, Rohwedder K, et al. Long-term efficacy of dapagliflozin in patients with type 2 diabetes mellitus receiving high doses of insulin: a randomized trial. Annals of internal medicine. 2012;156(6):405-15.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 F IFTIKHAR , Z RAFIQUE , Z ASGHAR , AW NIAZI , M IFTIKHAR , M MEHBOOB
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.