The association of weight loss with patient experience and outcomes in a population of patients with type 2 diabetes mellitus prescribed canagliflozin

Figures & data

Table 1 Patient demographics

Demographics	Canagliflozin N=205
	n	%
Gender
Male	100	48.8
Female	105	51.2
Age (years)
18–34	42	20.5
35–49	80	39.0
50–64	72	35.1
65–74	8	3.9
≥75	3	1.5
Mean BMI* (kg/m^2)	32.5
Ethnicity
American Indian/Alaskan Native	3	1.5
Asian/Pacific Islander	7	3.4
Black/African-American	34	16.6
Hispanic/Latino	20	9.8
White Caucasian	137	66.8
Multiracial	4	2.0
Region of residence (USA)
Mid-west	42	20.5
Northeast	43	21.0
South	91	44.4
West	29	14.1
Insurance type
Employer	100	48.8
Individual	40	19.5
Medicaid	16	7.8
Medicare	27	13.2
Uninsured	6	2.9
Other	1	0.5
Multiple	15	7.3
Disease duration
<1 year	7	3.4
1–5 years	114	55.6
6–10 years	39	19.0
>10 years	45	22.0
Medication use
3–<6 months	56	27.3
6 months – <1 year	84	41.0
1–<2 years	49	23.9
2–<5 years	16	7.8
≥5 years	NA	NA
Comorbidities
Anxiety	50	24.4
Depression	59	28.8
Hyperlipidemia	73	35.6
Hypertension	89	43.4
Joint pain/other chronic pain	62	30.2
Recent surgical procedure	7	3.4
Prefer not to answer	20	9.8

Notes:

* Mean BMI based on n=199.

Abbreviations: BMI, body mass index; NA, not applicable.

Table 2 Demographics by weight group

Demographics	Lost > 10 lbs N=46		Lost 5–10 lbs N=49		Lost < 5 lbs N=42		No Change N=34		Gained Weight N=34		p
	n	%	n	%	n	%	n	%	n	%
Gender
Male	21	45.7	20	40.8	25	59.5	19	55.9	15	44.1
Female	25	54.3	29	59.2	17	40.5	15	44.1	19	55.9
Age, years
18–34	4	8.7	11	22.4	12	28.6	8	23.5	7	20.6	<0.0158 B
35–49	12	26.1	16	32.7	17	40.5	22	64.7	13	38.2	<0.0040 C,F,H,J
50–64	24	52.2	18	36.7	13	31.0	4	11.8	13	38.2	<0.0460 B,C,F,H,J
65–74	4	8.7	4	8.2	0	0.0	0	0.0	0	0.0
≥ 75	2	4.3	0	0.0	0	0.0	0	0.0	1	2.9
Average BMI	33.0		31.5		32.4		31.7		34.3
Ethnicity
American Indian/Alaskan Native	0	0.0	1	2.0	1	2.4	1	2.9	0	0.0
Asian/Pacific Islander	1	2.2	2	4.1	1	2.4	1	2.9	2	5.9
Black/African-American	4	8.7	8	16.3	6	14.3	4	11.8	12	35.3
Hispanic/Latino	3	6.5	6	12.2	5	11.9	4	11.8	2	5.9
White Caucasian	38	82.6	32	65.3	28	66.7	22	64.7	17	50.0
Multiracial	0	0.0	0	0.0	1	2.4	2	5.9	1	2.9
Other	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0
Region of residence (USA)
Midwest	3	6.5	10	20.4	10	23.8	7	20.6	12	35.3
Northeast	11	23.9	12	24.5	6	14.3	6	17.6	8	23.5
South	23	50.0	20	40.8	20	47.6	16	47.1	12	35.3
West	9	19.6	7	14.3	6	14.3	5	14.7	2	5.9
Insurance type
Employer	22	47.8	31	63.3	23	54.8	14	41.2	10	29.4	<0.0470 F,G,I
Individual	3	6.5	7	14.3	9	21.4	8	23.5	13	38.2	<0.0420 B,C,D,G
Medicaid	5	10.9	1	2.0	2	4.8	4	11.8	4	11.8
Medicare	6	13.0	7	14.3	6	14.3	4	11.8	4	11.8
Uninsured	3	6.5	0	0.0	1	2.4	2	5.9	0	0.0
Other	0	0.0	0	0.0	0	0.0	1	2.9	0	0.0
Multiple	7	15.2	3	6.1	1	2.4	1	2.9	3	8.8	0.0364 B
Disease duration
<1 year	0	0.0	2	4.1	2	4.8	1	2.9	2	5.9
1–5 years	23	50.0	26	53.1	25	59.5	19	55.9	21	61.8
6–10 years	10	21.7	10	20.4	6	14.3	10	29.4	3	8.8
>10 years	13	28.3	11	22.4	9	21.4	4	11.8	8	23.5
Medication use
3–<6 months	7	15.2	17	34.7	11	26.2	11	32.4	10	29.4
6 months to <1 year	24	52.2	18	36.7	18	42.9	10	29.4	14	41.2
1–<2 years	12	26.1	13	26.5	9	21.4	9	26.5	6	17.6
2–< 5 years	3	6.5	1	2.0	3	7.1	4	11.8	4	11.8
≥ 5 years	0	0.0	0	0.0	1	2.4	0.0	0.0	0	0.0

Notes:

* Mean BMI based on: Lost >10 lbs, n=45; Lost 5–10lbs n=47; Lost <5 lbs, n=42; No Change, n=32; Gained Weight, n=33. Pairwise comparison notations:

A Lost > 10 lbs ≠ Lost 5–10 lbs;

B Lost >10 lbs ≠ Lost <5 lbs;

C Lost >10 lbs ≠ No Change;

D Lost >10 lbs ≠ Gained Weight;

E Lost 5–10 lbs ≠ Lost <5 lbs;

F Lost 5–10 lbs ≠ No Change;

G Lost 5–10 lbs ≠ Gained Weight;

H Lost <5 lbs ≠ No Change;

I Lost < 5 lbs ≠ Gained Weight;

J No Change ≠ Gained Weight. Bolded p-values indicate significant differences between groups.

Abbreviation: BMI, body mass index.

Table 3 Validated survey scales by weight group

Survey scales	Lost >10 lbs N=46		Lost 5–10 lbs N=49		Lost < 5 lbs N=42		No Change N=34		Gained Weight N=34		p
	Median	IQR	Median	IQR	Median	IQR	Median	IQR	Median	IQR
Health satisfaction
CHES-Q
Physical health satisfaction	0.17	0.50	0.17	0.67	0.17	0.67	0.17	0.50	0.33	0.50
Emotional health satisfaction	0.67	1.00	0.33	1.00	0.33	1.00	0.33	0.67	0.33	0.67
Treatment satisfaction
DTSQ
Treatment satisfaction scale total	28	8	28	7	28.5	10	26	10	27	7
Perceived frequency of hyperglycemia	2	1	4	3	3.5	3	4	3	4	2	<0.0480 A–D
Perceived frequency of hypoglycemia	2	3	2	3	2	2	3	3	3	3
Diabetes distress
DDS
Total DDS score	2.21	1.41	2.82	2.12	3.12	2.29	2.91	2.00	3.24	2.12	0.0063 D
Emotional burden	2.20	1.80	2.60	2.00	2.80	2.80	2.90	2.80	3.30	2.40	0.0246 C,D
Physician-related distress	2.00	2.00	2.25	2.00	2.75	2.75	2.75	2.25	3.13	2.75
Regimen-related distress	2.60	1.80	3.00	2.20	3.30	2.00	3.50	2.00	3.30	2.20	<0.0340 B–D
Interpersonal distress	2.33	2.00	2.67	2.67	3.00	2.67	2.83	2.67	3.83	2.67

Notes: Pairwise comparison notations:

A Lost > 10 lbs ≠ Lost 5–10 lbs;

B Lost >10 lbs ≠ Lost <5 lbs;

C Lost >10 lbs ≠ No Change;

D Lost >10 lbs ≠ Gained Weight. Bolded p-values indicate significant differences between groups.

Abbreviations: IQR, interquartile range; CHES-Q, Current Health Satisfaction Questionnaire; DTSQ, Diabetes Treatment Satisfaction Questionnaire; DDS, Diabetes Distress Scale.

Table 4 Medication satisfaction, engagement, and clinical indicators by weight group

	Lost >10 lbs N=46		Lost 5–10 lbs N=49		Lost <5 lbs N=42		No Change N=34		Gained Weight N=34		p
	n	%	n	%	n	%	n	%	n	%
Medication satisfaction
Compared to oral
Much better	22	47.8	24	49.0	11	26.2	6	17.6	9	26.5	<0.037 B,C,E–G
Better	16	34.8	20	40.8	21	50.0	14	41.2	12	35.3
Same	5	10.9	4	8.2	6	14.3	10	29.4	8	23.5	<0.036 C,F
Worse	1	2.2	0	0.0	2	4.8	2	5.9	2	5.9
Much worse	0	0.0	0	0.0	1	2.4	0	0.0	1	2.9
No previous oral medication	2	4.4	1	2.0	1	2.4	2	5.9	2	5.9
Compared to injectable
Much better	11	23.9	12	24.5	6	14.3	5	14.7	8	23.5
Better	16	34.8	17	34.7	12	28.6	9	26.5	10	29.4
Same	5	10.9	8	16.3	10	23.8	11	32.4	4	11.8	<0.018 C,J
Worse	1	2.2	1	2.0	1	2.4	0	0.0	4	11.8	0.0393 J
Much worse	0	0.0	0	0.0	0	0.0	0	0.0	2	5.9
No previous injectable medication	13	28.3	11	22.4	13	31.0	9	26.5	6	17.6
Patient engagement
Weight loss plan
No weight loss plan	2	4.3	4	8.2	7	16.7	11	32.4	3	8.8	<0.017 C,F,J
Intend to start plan in the next 6 months	2	4.3	6	12.2	4	9.5	6	17.6	7	20.6	0.0231 D
Intend to start plan in the next 30 days	5	10.9	6	12.2	6	14.3	7	20.6	8	23.5
Beginning to initiate plan	10	21.7	16	32.7	13	31.0	6	17.6	11	32.4
Engaged in plan for at least 6 months	27	58.7	17	34.7	12	28.6	4	11.8	5	14.7	<0.043 A,–D,F,G
Exercise plan
No exercise	5	10.9	9	18.4	5	11.9	5	14.7	3	8.8
Intend to start in the next 6 months	4	8.7	6	12.2	3	7.1	3	8.8	6	17.6
Intend to start in the next 30 days	10	21.7	7	14.3	8	19.0	9	26.5	10	29.4
Regular exercise for <6 months	14	30.4	10	20.4	14	33.3	6	17.6	9	26.5
Regular exercise for at least 6 months	13	28.3	17	34.7	12	28.6	11	32.4	6	17.6
Diet
No diet	5	10.9	7	14.3	3	7.1	5	14.7	5	14.7
Intend to start in the next 6 months	1	2.2	0	0.0	2	4.8	2	5.9	6	17.6	<0.016 D,G
Intend to start in the next 30 days	10	21.7	12	24.5	6	14.3	7	20.6	11	32.4
Dieting for <6 months	15	32.6	12	24.5	12	28.6	10	29.4	3	8.8	<0.032 D,I,J
Dieting for at least 6 months	15	32.6	18	36.7	19	45.2	10	29.4	9	26.5
Clinical factors
A1c level
Improved	34	75.6	33	75.0	23	57.5	16	51.6	14	43.8	<0.019 C,D,G
Got worse	3	6.7	6	13.6	7	17.5	1	3.2	12	37.5	<0.013 D,G,J
Stayed the same	8	17.8	5	11.4	10	25.0	14	45.2	6	18.8	<0.034 C,F,J
Blood glucose levels
Improved	34	79.1	35	81.4	21	53.8	18	58.1	12	40.0	<0.037 B,D,E,G
Got worse	5	11.6	3	7.0	7	17.9	0	0.0	8	26.7	<0.048 C,G,H,J
Stayed the same	4	9.3	5	11.6	11	28.2	13	41.9	10	33.3	<0.046 B–G
Blood pressure
Improved	19	47.5	28	59.6	17	43.6	9	33.3	7	22.6	<0.006 F,G
Got worse	5	12.5	4	8.5	5	12.8	1	3.7	10	32.3	<0.036 D,G,J
Stayed the same	16	40.0	15	31.9	17	43.6	17	63.0	14	45.2

Notes: Sample for A1c (n= 192), blood glucose level (n=186), and blood pressure (n=184) exclude patients who endorsed responses that they “did not discuss with their provider” or “do not remember”. Pairwise comparison notations:

A Lost > 10 lbs ≠ Lost 5–10 lbs;

B Lost >10 lbs ≠ Lost <5 lbs;

C Lost >10 lbs ≠ No Change;

D Lost >10 lbs ≠ Gained Weight;

E Lost 5–10 lbs ≠ Lost <5 lbs;

F Lost 5–10 lbs ≠ No Change;

G Lost 5–10 lbs ≠ Gained Weight;

H Lost <5 lbs ≠ No Change;

I Lost < 5 lbs ≠ Gained Weight;

J No Change ≠ Gained Weight. Bolded p-values indicate significant differences between groups.

Table 5 Correlations between weight groups and scale scores

		CHES-Q		DDS					DTSQ
		Physical health satisfaction	Emotional health satisfaction	Total DDS score	Emotional burden	Physician-related distress	Regimen-related distress	Interpersonal distress	Treatment satisfaction score	Hyperglycemia	Hypoglycemia
Gained	Correlation	0.029	−0.052	0.094	0.11	0.079	0.079	0.087	−0.06	0.127	0.034
Weight	Sig (two-tailed)	0.675	0.462	0.178	0.115	0.262	0.262	0.213	0.392	0.069	0.633
	N	205	205	205	205	205	205	205	205	205	205
No	Correlation	−0.056	−0.02	0.069	0.059	0.072	0.073	0.057	−0.124	0.039	0.104
Change	Sig (two-tailed)	0.423	0.773	0.325	0.402	0.306	0.298	0.418	0.077	0.581	0.137
	N	205	205	205	205	205	205	205	205	205	205
Lost	Correlation	0.028	−0.041	0.056	0.062	0.051	0.064	0.023	0.034	0.072	0.009
<5 lbs	Sig (two-tailed)	0.691	0.563	0.426	0.375	0.465	0.362	0.745	0.627	0.302	0.898
	N	205	205	205	205	205	205	205	205	205	205
Lost	Correlation	0.016	0.008	−0.033	−0.037	−0.03	−0.03	−0.027	0.102	0.052	0.021
5−10 lbs	Sig (two-tailed)	0.824	0.905	0.638	0.603	0.673	0.67	0.696	0.145	0.461	0.762
	N	205	205	205	205	205	205	205	205	205	205
Lost	Correlation	−0.019	0.095	−0.166***	−0.174***	−0.154***	−0.167***	−0.123	0.026	−0.271**	−0.153***
>10 lbs	Sig (two-tailed)	0.786	0.176	0.017	0.013	0.028	0.017	0.08	0.708	0	0.028
	N	205	205	205	205	205	205	205	205	205	205

Notes:

** Correlation is significant at the 0.01 level (2-tailed).

*** Correlation is significant at the 0.05 level (two-tailed).

Abbreviations: CHES -Q, Current Health Satisfaction Questionnaire; DTSQ, Diabetes Treatment Satisfaction Questionnaire; DDS, Diabetes Distress Scale; Sig, significant.