In a nutshell
The aim of this study was to compare the effects of switching from pioglitazone to dapagliflozin on body weight and blood glucose control in the treatment of type 2 diabetes (T2D). The main finding was that there was greater weight loss seen with dapagliflozin, with similar blood glucose control.
In T2D, patients have insulin resistance. This is when the cells in the body are not sensitive to insulin (the hormone that controls blood sugar) anymore. Therefore, the body cannot use glucose as energy and blood glucose levels remain high.
There are many different types of drugs used in the treatment of T2D. Pioglitazone (Actos) works by decreasing insulin resistance. However, this drug cannot be used in patients with heart failure. Studies have shown that there is a high number of patients with T2D who have undiagnosed heart failure. Therefore, there is a risk that this drug may be given to patients with undiagnosed heart failure. Heart failure can be measured by measuring a protein in the blood called NT-pro BNP.
Dapagliflozin (Forxiga, Farxiga) is another drug for T2D. It works by removing excess sugar from the body via the urine. It has been shown to have some heart-protective properties. It is unknown how dapagliflozin and pioglitazone compare in terms of weight loss and blood glucose control in the treatment of T2D.
Methods & findings
This study included 71 patients with T2D treated with pioglitazone (PIO). Patients were either switched to dapagliflozin (DAP, 36 patients) or continued on PIO (35 patients). Patients were treated for 24 weeks. Blood glucose control was measured by HbA1c (blood test giving average blood glucose for the past three months).
After 24 weeks, changes in HbA1c were similar in both groups. However, patients who had been switched to DAP had a greater reduction in body weight compared to those who remained on PIO. There was also a significant decrease in NT-pro BNP and improved kidney function tests in patients treated with DAP.
The bottom line
The authors concluded that dapagliflozin is similar to pioglitazone for blood glucose control in T2D and can significantly reduce body weight. In addition, the authors suggested that dapagliflozin may have other beneficial effects on heart and kidney function.
The fine print
This study was small. Larger studies are needed.
Published By :
Diabetes, Obesity and Metabolism
Oct 12, 2018
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