Association between clinical and laboratory factors and response to sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes: a retrospective observational study

ABSTRACT

Background

This study aimed to investigate the association between clinical and laboratory parameters and response to therapy with sodium-glucose cotransporter 2 inhibitors (SGLT2i) in patients with type 2 diabetes mellitus (T2D).

Research design and methods

We retrospectively analyzed the medical records of people with T2D in whom SGLT2i was started. Clinical and laboratory parameters were recorded before, 3 and 6 months after starting treatment. Specific criteria were applied to classify participants into good and poor responders in terms of weight loss (primary outcome) and glycemic control (secondary outcome), separately.

Results

Fifty individuals (64% men) with a mean age of 65.8 ± 8.5 years were included in the analysis. 86% and 64% of the participants were classified into good response categories for glycemic control and weight loss, respectively. Good responders in terms of glycemic control had lower high-density lipoprotein cholesterol levels at baseline compared to poor responders (43.3 vs 57.4 mg/dl, p = 0.044). In the logistic regression analysis, a higher baseline weight was associated with a better response to therapy in terms of weight loss (p = 0.04).

Conclusions

Our findings suggest that specific clinical and laboratory parameters are associated with response to SGLT2i treatment and can contribute to a more personalized approach to T2D care.

KEYWORDS:

• SGLT2 inhibitors
• type 2 diabetes
• weight loss
• personalized medicine
• HbA1c

Declaration of interest

T Koufakis has received honoraria for lectures from AstraZeneca, Boehringer Ingelheim, Pharmaserve Lilly, and Novo Nordisk, for advisory boards from Novo Nordisk, Pharmaserve Lilly and Boehringer Ingelheim, and has participated in sponsored studies by Eli-Lilly, AstraZeneca and Novo Nordisk.

V Tsimihodimos has received honoraria for lectures/advisory boards and research support from Astra Zeneca, Boehringer Ingelheim, Pharmaserve Lilly, Sanofi-Aventis, ELPEN, MSD, Winmedica, Servier, Abbot, and Novo Nordisk.

K Kotsa has received honoraria for lectures/advisory boards and research support from Astra Zeneca, Boehringer Ingelheim, Pharmaserve Lilly, Sanofi-Aventis, ELPEN, MSD and Novo Nordisk.

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Author contributions

S Pitsiava collected all data. G Dimakopoulos performed the statistical analysis and contributed to the interpretation of the data. V Tsimihodimos and K Kotsa contributed to the literature review and interpretation of data. T Koufakis conceptualized and designed the study, wrote the manuscript and contributed to data interpretation. All authors have read and critically reviewed the manuscript and approved the final version.

Data availability statement

The data presented in the study are available on reasonable request from the corresponding author.

Ethical approval

The research protocol was approved by the Ethics Committee of the AHEPA University Hospital (approval number 2788, approval date 19-06-23).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.