제2형 당뇨병 환자에서 Dapagliflozin이 혈당과 심혈관계질환 위험인자에 미치는 영향 및 안전성
Dapagliflozin's Effects on Glycemia and Cardiovascular Risk Factors and Incidence of Adverse Events in Patients with Type 2 Diabetes
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Background: Dapagliflozin is an oral selective inhibitor of sodium-glucose cotransporter 2(SGLT2), the kidney transporter chieflyresponsible for glucose reabsorption from the glomerular filtrate. Because this mechanism does not require the action of insulin,dapagliflozin rarely causes hypoglycemia. Dapagliflozin may affect blood glucose control as well as blood pressure and the bodyweight which are one of the cardiovascular disease risk factors. However, dehydration and ketoacidosis are reported as the sideeffects of the dapagliflozin treatment and the safety issues have been occurred. The aim of this study is to analyze the effectivenessand adverse events of dapagliflozin in Korean patients. Methods: From December 2014 to August 2015, we retrospectively reviewedthe electronic medical records of type 2 diabetes patients who were prescribed dapagliflozin at Severance Hospital. Results: A totalof 202 Korean patients were enrolled in this study. The effectiveness in the reduction of blood glucose was statisticallysignificant(p<0.001). Dapagliflozin decreased 0.74% of HbA1c after 24 weeks. Significantly more participants achieved the targetHbA1c level(HbA1c<7%) after 24 weeks(n=42, 35.3%) than before taking dapagliflozin(n=21, 17.6%). Blood pressure decreased 5.7mmHg s ystolic b lood p ressure(SBP), 1.9 mmHg d iastolic b lood p ressure(DBP) a fter 24 weeks. M ore than o ne q uarter ofparticipants(n=35, 29.4%) experienced weight loss. Most common adverse event was genitourinary symptoms. Conclusion: In thisstudy, the effectiveness of dapagliflozin in improving glycemic control, blood pressure control, and weight loss was statisticallysignificant. However, elderly and female patients, who have higher incidence of adverse events, should use dapagliflozin cautiously.
Abstract
Background: Dapagliflozin is an oral selective inhibitor of sodium-glucose cotransporter 2(SGLT2), the kidney transporter chieflyresponsible for glucose reabsorption from the glomerular filtrate. Because this mechanism does not require the action of insulin,dapagliflozin rarely causes hypoglycemia. Dapagliflozin may affect blood glucose control as well as blood pressure and the bodyweight which are one of the cardiovascular disease risk factors. However, dehydration and ketoacidosis are reported as the sideeffects of the dapagliflozin treatment and the safety issues have been occurred. The aim of this study is to analyze the effectivenessand adverse events of dapagliflozin in Korean patients. Methods: From December 2014 to August 2015, we retrospectively reviewedthe electronic medical records of type 2 diabetes patients who were prescribed dapagliflozin at Severance Hospital. Results: A totalof 202 Korean patients were enrolled in this study. The effectiveness in the reduction of blood glucose was statisticallysignificant(p<0.001). Dapagliflozin decreased 0.74% of HbA1c after 24 weeks. Significantly more participants achieved the targetHbA1c level(HbA1c<7%) after 24 weeks(n=42, 35.3%) than before taking dapagliflozin(n=21, 17.6%). Blood pressure decreased 5.7mmHg s ystolic b lood p ressure(SBP), 1.9 mmHg d iastolic b lood p ressure(DBP) a fter 24 weeks. M ore than o ne q uarter ofparticipants(n=35, 29.4%) experienced weight loss. Most common adverse event was genitourinary symptoms. Conclusion: In thisstudy, the effectiveness of dapagliflozin in improving glycemic control, blood pressure control, and weight loss was statisticallysignificant. However, elderly and female patients, who have higher incidence of adverse events, should use dapagliflozin cautiously.
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