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You Jin Kim  (Kim YJ) 1 Article
Clinical Diabetes & Therapeutics
Predictors of the Therapeutic Efficacy and Consideration of the Best Combination Therapy of Sodium-Glucose Co-transporter 2 Inhibitors
Ji-Yeon Lee, Yongin Cho, Minyoung Lee, You Jin Kim, Yong-ho Lee, Byung-Wan Lee, Bong-Soo Cha, Eun Seok Kang
Diabetes Metab J. 2019;43(2):158-173.   Published online January 25, 2019
DOI: https://doi.org/10.4093/dmj.2018.0057
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  • 15 Web of Science
  • 15 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   
Background

We investigated the predictive markers for the therapeutic efficacy and the best combination of sodium-glucose co-transporter 2 (SGLT2) inhibitors (empagliflozin, dapagliflozin, and ipragliflozin) therapy in patients with type 2 diabetes mellitus (T2DM).

Methods

A total of 804 patients with T2DM who had taken SGLT2 inhibitor as monotherapy or an add-on therapy were analyzed. Multivariate regression analyses were performed to identify the predictors of SGLT2 inhibitor response including the classes of baseline anti-diabetic medications.

Results

After adjusting for age, sex, baseline body mass index (BMI), diabetes duration, duration of SGLT2 inhibitor use, initial glycosylated hemoglobin (HbA1c) level, estimated glomerular filtration rate (eGFR), and other anti-diabetic agent usage, multivariate analysis revealed that shorter diabetes duration, higher initial HbA1c and eGFR were associated with better glycemic response. However, baseline BMI was inversely correlated with glycemic status; lean subjects with well-controlled diabetes and obese subjects with inadequately controlled diabetes received more benefit from SGLT2 inhibitor treatment. In addition, dipeptidyl peptidase 4 (DPP4) inhibitor use was related to a greater reduction in HbA1c in patients with higher baseline HbA1c ≥7%. Sulfonylurea users experienced a larger change from baseline HbA1c but the significance was lost after adjustment for covariates and metformin and thiazolidinedione use did not affect the glycemic outcome.

Conclusion

A better response to SGLT2 inhibitors is expected in Korean T2DM patients who have higher baseline HbA1c and eGFR with a shorter diabetes duration. Moreover, the add-on of an SGLT2 inhibitor to a DPP4 inhibitor is likely to show the greatest glycemic response.

Citations

Citations to this article as recorded by  
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    Diabetes/Metabolism Research and Reviews.2024;[Epub]     CrossRef
  • Short-term effectiveness of dapagliflozin versus DPP-4 inhibitors in elderly patients with type 2 diabetes: a multicentre retrospective study
    M. L. Morieri, I. Raz, A. Consoli, M. Rigato, A. Lapolla, F. Broglio, E. Bonora, A. Avogaro, G. P. Fadini, Federica Ginestra, Gloria Formoso, Agostino Consoli, Francesco Andreozzi, Giorgio Sesti, Salvatore Turco, Luigi Lucibelli, Adriano Gatti, Raffaella
    Journal of Endocrinological Investigation.2023; 46(7): 1429.     CrossRef
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    Communications Medicine.2023;[Epub]     CrossRef
  • Predictors of HbA1c treatment response to add-on medication following metformin monotherapy: a population-based cohort study
    Wei Ying Tan, Wynne Hsu, Mong Li Lee, Ngiap Chuan Tan
    Scientific Reports.2023;[Epub]     CrossRef
  • Efficacy and Safety of Evogliptin Add-on Therapy to Dapagliflozin/Metformin Combinations in Patients with Poorly Controlled Type 2 Diabetes Mellitus: A 24-Week Multicenter Randomized Placebo-Controlled Parallel-Design Phase-3 Trial with a 28-Week Extensio
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    Diabetes & Metabolism Journal.2023; 47(6): 808.     CrossRef
  • Effect of Dapagliflozin as an Add-on Therapy to Insulin on the Glycemic Variability in Subjects with Type 2 Diabetes Mellitus (DIVE): A Multicenter, Placebo-Controlled, Double-Blind, Randomized Study
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    Diabetes & Metabolism Journal.2021; 45(3): 339.     CrossRef
  • Angiotensin II up-regulates sodium-glucose co-transporter 2 expression and SGLT2 inhibitor attenuates Ang II-induced hypertensive renal injury in mice
    Kana N. Miyata, Chao-Sheng Lo, Shuiling Zhao, Min-Chun Liao, Yuchao Pang, Shiao-Ying Chang, Junzheng Peng, Matthias Kretzler, Janos G. Filep, Julie R. Ingelfinger, Shao-Ling Zhang, John S.D. Chan
    Clinical Science.2021; 135(7): 943.     CrossRef
  • Sodium-Glucose Cotransporter-2 Inhibitor for Renal Function Preservation in Patients with Type 2 Diabetes Mellitus: A Korean Diabetes Association and Korean Society of Nephrology Consensus Statement
    Tae Jung Oh, Ju-Young Moon, Kyu Yeon Hur, Seung Hyun Ko, Hyun Jung Kim, Taehee Kim, Dong Won Lee, Min Kyong Moon
    Diabetes & Metabolism Journal.2020; 44(4): 489.     CrossRef
  • Differential indication for SGLT-2 inhibitors versus GLP-1 receptor agonists in patients with established atherosclerotic heart disease or at risk for congestive heart failure
    Francesco Giorgino, Irene Caruso, Julia Moellmann, Michael Lehrke
    Metabolism.2020; 104: 154045.     CrossRef
  • Clinical Predictors of the Hypoglycemic Effect of Sodium–Glucose Co-transporter-2 Inhibitors in Hyperuricemic Patients: A Retrospective Descriptive Observational Study
    Toshinori Hirai, Yuya Kawagoe, Motoki Kei, Ryuichi Ogawa, Toshimasa Itoh
    Biological and Pharmaceutical Bulletin.2020; 43(5): 782.     CrossRef
  • Sodium-glucose cotransporter-2 inhibitor for renal function preservation in patients with type 2 diabetes mellitus: A Korean Diabetes Association and Korean Society of Nephrology consensus statement
    Tae Jung Oh, Ju-Young Moon, Kyu Yeon Hur, Seung Hyun Ko, Hyun Jung Kim, Taehee Kim, Dong Won Lee, Min Kyong Moon
    Kidney Research and Clinical Practice.2020; 39(3): 269.     CrossRef
  • Efficacy of Once-Weekly Semaglutide vs Empagliflozin Added to Metformin in Type 2 Diabetes: Patient-Level Meta-analysis
    Ildiko Lingvay, Matthew S Capehorn, Andrei-Mircea Catarig, Pierre Johansen, Jack Lawson, Anna Sandberg, Robert Shaw, Abby Paine
    The Journal of Clinical Endocrinology & Metabolism.2020; 105(12): e4593.     CrossRef
  • Letter: Predictors of the Therapeutic Efficacy and Consideration of the Best Combination Therapy of Sodium-Glucose Co-transporter 2 Inhibitors (Diabetes Metab J 2019;43:158–73)
    Kyung-Soo Kim
    Diabetes & Metabolism Journal.2019; 43(3): 377.     CrossRef
  • Response: Predictors of the Therapeutic Efficacy and Consideration of the Best Combination Therapy of Sodium-Glucose Co-transporter 2 Inhibitors (Diabetes Metab J 2019;43:158–73)
    Ji-Yeon Lee, Eun Seok Kang
    Diabetes & Metabolism Journal.2019; 43(3): 379.     CrossRef
  • An Age of Sodium-Glucose Cotransporter-2 Inhibitor Priority: Are We Ready?
    Ji A Seo
    Diabetes & Metabolism Journal.2019; 43(5): 578.     CrossRef

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