1Senior Consultant Endocrinologist, MRCP (UK), CCT-GIM (UK), CCT Diabetes and Endocrinology (UK), Apollo Hospitals, Jubilee Hills, Hyderabad, Telangana, 500096
2PhD scholar - Pharmacy Practice, Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India
3Doctor of Pharmacy (Pharm D), MSc Clinical and Translational Research, University College Dublin, Dublin, Ireland
4Drug Safety Associate, Pharm D, Parexel, Madhapur, Hyderabad
5Doctor of Pharmacy (Pharm D), Apollo Hospitals, Jubilee Hills, Hyderabad
6Doctor of Pharmacy (Pharm D), Physician Assistant, Apollo Hospitals, Jubilee Hills, Hyderabad
7Doctor of Pharmacy (Pharm D), Physician Assistant, Apollo Hospitals, Jubilee Hills, Hyderabad
The aim of this study is to assess the efficacy and safety of dapagliflozin versus vildagliptin in type 2 diabetes patients receiving baseline metformin alone or metformin + sulfonylureas in combination.
Our study is a prospective, observational study. Participants (N = 26) with type 2 diabetes aged ≥ 18 years who had inadequate glycaemic control on metformin alone or metformin + sulfonylureas combination received dapagliflozin 10mg or vildagliptin 100mg for 24 weeks. The patients in both groups are compared for outcomes like HbA1c, and hypoglycaemic incidence.
At week 24, Dapagliflozin showed superiority in the reduction of HbA1c in combination with metformin (median reduction, -1%; 7.68 at baseline vs 6.6 at 24th week) compared to metformin + vildagliptin (median reduction, -0.5%;7.21 at baseline vs 6.83 at 24th week). Similarly, dapagliflozin showed a higher reduction of HbA1c when given in combination with metformin + sulfonylureas (median reduction, -1.7%; 9.76 at baseline vs 8.0 at 24th week) compared to vildagliptin given in combination with metformin + sulfonylureas (median reduction, -0.8%; 7.35 at baseline vs 6.55 at 24th week). No incidence of hypoglycaemia was observed in both the groups. One patient on metformin + dapagliflozin had a urinary tract infection during the study period.
In this real-world study, T2DM patients treated with metformin + dapagliflozin achieved their HbA1c goal more effectively than those treated with metformin + vildagliptin. Similarly, a higher reduction in median HbA1c was observed in patients treated with dapagliflozin, metformin, and sulfonylureas than those on vildagliptin-based triple therapy; however, this was due to their higher baseline HbA1c. In managing T2DM, both medications have been found to be safer in terms of hypoglycaemia incidence.
Dapagliflozin, Vildagliptin, Type 2 DM, Metformin, Sulfonylureas
