Improved changes in the eye in patients with type 2 diabetes using dapagliflozin compared to glibenclamide.

This study investigated the change in central retinal thickness (CRT) by optical coherence tomography (OCT) in patients with type 2 diabetes (T2D) after 12 weeks of treatment with dapagliflozin (Farxiga) or glibenclamide (Diabeta). The authors concluded that CRT may improve with short-term use of dapagliflozin compared with glibenclamide treatment.

Diabetic retinopathy (DR) is a complication of diabetes and a leading cause of blindness. DR is associated with blood vessel damage in the retina (light-sensitive tissues at the back of the eyes). At the early stages of DR development, symptoms are not detectable. However, detection of decreases (thinning) in CRT is possible using optical coherence tomography (OCT; a non-invasive, light-imaging technique for high-resolution retina images).

In patients with T2D, nerve degeneration in the retina and nerve fiber loss are linked to progressive thinning of the retina. Some evidence suggests that empagliflozin (Jardiance), a sodium-glucose co-transporter 2 inhibitor (SGLT2i), may delay the time of laser eye surgery. There is a need to explore whether there is delayed onset of the progressive, thinning effects on CRT using OCT after treatment with glibenclamide (a sulfonylurea drug) and dapagliflozin (an SGLTi) in patients with T2D.

This study included 97 patients with T2D. All patients received metformin (Glucophage) treatment. Patients were randomly assigned to two groups. One group received dapagliflozin 10 mg daily. The second group was given glibenclamide 5 mg daily. OCT was done at the beginning and at the end of the study. Patients were followed up for 12 weeks.

Overall, no differences in change in DR status were seen after therapy. However, patients treated with dapagliflozin had an improvement in retinal thickness compared to those treated with glibenclamide. The dapagliflozin group had a center subfield thickness change of +2(6)mm, while those that received glibenclamide had a change by -1(7) mm. Both groups had similar blood glucose control.

The study showed that treatment with dapagliflozin may increase CRT compared to glibenclamide in patients with T2D.

The study focused on patients in the early stages of diabetes and the follow-up period was short. This study was sponsored by AstraZeneca, the manufacturer of dapagliflozin.