Endocrine Abstracts

In clinical trials, the SGLT2 inhibitor Canagliflozin inhibits renal reabsorption of glucose, increases its excretion and reduces hyperglycaemia in patients with type 2 diabetes mellitus (T2DM). The increase in glucosuria and diuresis produced, results in a reduction in weight and blood pressure (BP). Moreover, It may cause genital and urinary tract infections. However, does Canagliflozin behave in the same way in routine clinical practice?

Objective: To make a short-term assessment in routine clinical practice of the efficacy and safety of Canagliflozin in patients with T2DM.

Material and methods: Thirty-three T2DM patients of 60.4±10.9 years of age and 13.6±7.3 years of evolution (12 women, 21 men), with BMI>30 kg/m², HbA1C>7% and glomerular filtration >60 ml/min, had Canagliflozin 100 mg/day added to their treatment in monotherapy (n=2), double therapy (n=6), triple therapy (n=7), oral antidiabetic drugs (OADS)+basal Insulin (n=5), OADS+basal bolus (n=10); OADS+rapid insulin (n=1) and basal bolus (n=2). They were weighed and HbA1C, fasting glucose (FG), systolic BP (SBP) and diastolic BP (DBP) were measured, before and 3 months after adding Canagliflozin. A P<0.05 was considered significant (SPSS, v. 20.0).

Results: At 3 months, a reduction in weight (P<0.001), HbA1C (P=0.000), FG (P=0.000) and SBP (P<0.01) was observed. Average reduction in weight was 3.45±2.9 kg, 1.13±0.83% in HbA1C, and 7.7±8.6 mmHg in SBP; 69.2% achieved HbA1C<7% with a reduction in weight and SBP. Only two genital (6%) and one urinary tract (3%) infections were observed.

Conclusion: In clinical practice and in the short-term, Canagliflozin added to the treatment of poorly controlled and obese T2DM patients, at any therapeutic level, was translated into a reduction in weight, HbA1C and SBP in more than 2/3 parts, with few adverse effects. Long-term studies with more number of patients should be conducted to find out whether the results are maintained.