MedWire News: The newly developed sodium-glucose co-transporter 2 (SGLT2) inhibitor dapagliflozin effectively improves hyperglycemia and assists weight loss in Type 2 diabetics by inducing controlled excretion of glucose into the urine, show study results.
“Glucose reabsorption by the kidney is necessary from an evolutionary standpoint to retain calories but becomes detrimental in Type 2 diabetes by contributing to perpetuation of hyperglycemia and caloric excess,” explain James List (Bristol-Myers Squibb, Princeton, New Jersey, USA) and colleagues.
“Therefore, limiting renal glucose reabsorption through the inhibition of SGLT2 represents a new approach to treating hyperglycemia in Type 2 diabetic patients.”
In this study, 389 Type 2 diabetes patients were randomly assigned to one of five doses of dapagliflozin (2.5, 5, 10, 20, or 50 mg/day), metformin XR 750–1500 mg/day, or placebo for a period of 12 weeks.
Writing in the journal Diabetes Care, the researchers report that patients treated with dapagliflozin achieved significant reductions in glycated hemoglobin (HbA1c) of between 0.55 and 0.90%, compared with a reduction of 0.73% among individuals treated with metformin XR and 0.18% among placebo-treated patients. This was mainly due to an induction of moderate glucosuria (52–85 g urinary glucose/day).
Fasting plasma glucose was also significantly reduced at 12 weeks in dapagliflozin treated individuals by 16–31 mg/dl, compared with a reduction of 18 mg/dl in the metformin group and 6 mg/dl in the placebo group.
Weight loss was greatest in patients receiving dapagliflozin, ranging from a reduction of 2.5% to 3.4% of total body weight versus a reduction of 1.7% in the metformin and 1.2% in the placebo groups.
List and co-workers found that adverse events were reported at a similar frequency across all groups and that no drug-related serious adverse events or deaths occurred during the study period.
They conclude: “On the basis of evidence to date, further clinical study of dapagliflozin is warranted to develop a more definitive benefit/risk profile for this novel therapeutic agent.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009
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