ECE2019 Poster Presentations Diabetes, Obesity and Metabolism 3 (112 abstracts)
UGC Endocrinología y Nutrición Hospital Universitario San Cecilio, Granada, Spain.
Objectives: Assess the canagliflozin effect on the ABPI in patients without previous treatment with iSGLT-2 as a possible etiology of tissue hypoperfusion and a risk factor for amputations.
Material and methods: Prospective observational study where we analyzed patients diagnosed of type 2 diabetes mellitus (DM2) with poor metabolic control and without prior treatment with iSGLT-2, which is initiated treatment with canagliflozin. Clinical, biochemical parameters and baseline and after two months-advers events were analyzed. Statistical analysis (SPSS v. 20.0): Students t test for paired samples.
Results: We analyzed 12 patients (58.3% males). 16.7% of active smokers and 41.7% of ex-smokers. 66.7% hypertensive and dyslipidemic. Microvascular complications: 25% nephropathy, 8.3% retinopathy and 16.7% diabetic neuropathy. Macrovascular complications: 25% ischemic heart disease, 8.3% cerebrovascular accident and none present chronic ischaemia. 58.3% were in the treatment with antidiabetic agents and the rest of them with insulin (basal, basal-plus and basal-bolus) and antidiabetic agents+aGLP1. Table 1 shows the basal anthropometric and clinical characteristics and 2 months after starting new treatment.Results: significant weight reduction: 3.35 kg (P=0.002), basal glycaemia: 50.5 mg/dl (P=0.007) and HbA1c:1.15% (P=0.016).There are no significant changes in ketonemia. The reduction of ABPI or GFR was not statistically significant. Treatment was withdrawn in two patients due to genitourinary complications, there were no macrovascular events, hospitalizations or deaths.
Variable | Mean | Standard deviation |
Age (years) | 48 | 8,64 |
Size (cm) | 1,56 | 0,065 |
Pre-Weight (kg) | 57,50 | 18,66 |
Pre-BMI (kg/m2) | 22,50 | 7,41 |
Doses of insulin (UI) | 15 | 15,45 |
Pre-glucose (mg/dl) | 102 | 55,66 |
Pre-HbA1c (%) | 7,1 | 1,47 |
Pre-uric (mg/dl) | 3,30 | 1,09 |
Pre-total cholesterol (mg/dl) | 110 | 39,65 |
Pre-LDL (mg/dl) | 29 | 35,81 |
Pre-HDL (mg/dl) | 27 | 12,95 |
Pre-triglycerides (mg/dl) | 71 | 108,17 |
Pre-creatinine (mg/dl) | 12 | 0,77 |
Pre-glomerular filtration (GFR) (ml/min) | 47 | 17,20 |
Pre-left ABPI | 0,80 | 0,13 |
Pre-right ABPI | 0,60 | 0,21 |
Pre-Ketone bodies (mmol/l) | 0,10 | 0,04 |
Post-weight (kg) | 56,00 | 18,48 |
Conclusions: This study shows the safety of canagliflozin in patients with reduced ABPI, with no amputations during this time period. Its advisable to expand the number of patients and the follow-up time to obtain more consistent results.