Endocrine Abstracts

Introduction: The emergence of a new generation of antidiabetic drugs (GLP-1RA and SGLT-2i) with complementary mechanisms of action offer new alternatives in the treatment of patients with T2D and poor metabolic control.

Objectives: To evaluate the efficacy of the aGLP-1 and iSGLT2 combination on metabolic control, weight, blood pressure and insulin dose in patients with DM2.

Methods: Observational, retrospective study. We studied T2D patients whose habitual treatment had been modified on their last visit, using a combination of GLP-1RA and SGLT2i.

Results: 36 patients: 56% women, age 59.1±10.0 years, T2D evolution time 11.3±6.5 years, 64% taking insulin. They presented: 77% hypertension, 71% dyslipidemia, 18% retinopathy, 8% nephropathy and 8% neuropathy. As GLP-1RA, 40% used liraglutide, 34% dulaglutide, 22% exenatide-LAR and 3% lixisenatide. As iSGLT-2, 90% used dapagliflozin, 6% empagliflozin and 3% canagliflozin. After four months of treatment, there was a significant decrease in weight (100.0±26 kg vs 96.9±25.2 kg), BMI (37.2±8 kg/m² vs 35.8±7.6 kg/m²), HbA1c (8.56±1.2% vs 7.6±0.7%), fasting glycemia (168.6±37.9 mg/dl vs 147.7±34.6 mg/dl) and insulin dose (53.7±40.2 IU vs. 47.0±31.4 IU). Also, we found a significative decrease in AST (30±13.8 U/l vs 24.9±1 U/l), consequently decreasing HSI (hepatic steatosis index; 47.3±9.4 vs 45.5±9.3). There were no significant changes in blood pressure, lipid profile or ALT.

Conclusion: 1) We observed statistically significant decrease in weight, HbA1c, fasting glycemia and insulin dose. 2) There was significant reduction in AST. 3) Further studies are needed to distinguish which type of patient benefits more from this combination.