Acta Scientific Gastrointestinal Disorders (ASGIS)(ISSN: 2582-1091)

Research Article Volume 6 Issue 3

Experience of Using Sodium-dependent Glucose Cotransporter Type 2 Inhibitors in Comorbid Patients in Real Clinical Practice

Kravchun NO, Dunaieva IP and Kravchun PP*

Kharkiv National Medical University, Ukraine

*Corresponding Author: Kravchun PP, Kharkiv National Medical University, Ukraine. ORCID Details: Inna Dunaieva - 0000-0003-3061-3230, Nonna Kravchun - 0000-0001-7222-8424, Pavlo Povlovych Kravchun - 0000-0001-7671-1077.

Received: January 10, 2023; Published: February 08, 2023


Inhibitors of sodium-dependent glucose cotransporter type 2 (SGLT2i) are drugs that protect against cardiovascular diseases and mortality in patients with diabetes mellitus (DM) type 2 of various age groups with the presence of comorbid pathology and numerous complications. The huge number of achieved results may vary in different cases, but already existing data prove the importance and necessity of prescribing such innovative drugs as SGLT2i. So far, the effectiveness and necessity of using SGLT2i has been proven not only in patients with type 2 diabetes, but also in patients with heart failure and chronic kidney disease without diabetes.

The Aim of the Study: An analysis of the long-term results of the influence of combined therapy with dapagliflozin and metformin on the state of carbohydrate, lipid and protein metabolism, indicators of liver tests and synthetic liver function in patients with type 2 diabetes, representatives of the Ukrainian population, who have signs of high cardiovascular risk.

Materials and Methods: The study included 60 patients with type 2 diabetes, of whom 34 were men and 26 were women. The average age of the patients was (57.52 ± 0.96) years. 39 (65.0%) patients had diabetes of moderate severity, 21 (35.0%) had severe diabetes. 11 patients (18.3%) received combined therapy including insulin. Treatment of patients with type 2 diabetes included adherence to dietary recommendations, namely, nutritional correction and the appointment of tableted oral hypoglycemic agents: dapagliflozin in a daily dose of 10 mg and metformin in a daily dose of 1500 to 2000 mg; 11 patients were additionally prescribed insulin therapy in addition to the oral hypoglycemic drugs. Determination of the level of carbohydrate, lipid, and protein metabolism, indicators of liver tests, and liver synthetic function were performed in all patients.

Results: Long-term treatment with dapagliflozin in combination with metformin in patients with type 2 diabetes with a high cardiovascular risk has proven its effectiveness. A significant improvement in carbohydrate, lipid, and protein metabolism indicators, liver test results, and liver synthetic function was established in the treated patients.

Conclusions: The expediency and effectiveness of using the combination of the drug dapagliflozin in combination with metformin as a long-term glucose-lowering therapy for patients with type 2 diabetes with comorbid pathology and high cardiovascular risk have been substantiated.

Keywords: Comorbid Patients; Type 2 Diabetes; High Cardiovascular Risk; Sodium-dependent Glucose Cotransporter Type 2 Inhibitors


  1. JG Alan., et al. “Consensus statement by the american association of clinical endocrinologists and american college of endocrinology on the comprehensive type 2 diabetes management algorithm - 2020 executive summary”. Endocrine Practice1 (2020): 107-139.
  2. K I Birkeland., et al. “Cardiovascular mortality and morbidity in patients with type 2 diabetes following initiation of sodium-glucose cotransporter-2 inhibitors versus other glucose-lowering drugs (CVD-REAL Nordic): a multinational observational analysis”. Lancet Diabetes Endocrinology9 (2017): 709-717.
  3. F Persson., et al. “Dapagliflozin is associated with lower risk of cardiovascular events and all-cause mortality in people with type 2 diabetes (CVD-REAL Nordic) when compared with dipeptidyl peptidase-4 inhibitor therapy: A multinational observational study”. Diabetes, Obesity and Metabolism 2 (2018): 344-351.
  4. M Kosiborod., et al. “Cardiovascular Events Associated With SGLT-2 Inhibitors Versus Other Glucose-Lowering Drugs: The CVD-REAL 2 Study”. Journal of the American College of Cardiology23 (2018): 2628-2639.
  5. G Kyriakos., et al. “SGLT2 inhibitors and cardiovascular outcomes: Do they differ or there is a class effect? New insights from the EMPA-REG OUTCOME trial and the CVD-REAL Study”. Current Cardiology Reviews 29 (2019): 12-24.
  6. K Imprialos., et al. “SGLT-2 Inhibitors and Cardiovascular Risk in Diabetes Mellitus: A Comprehensive and Critical Review of the Literature”. Current Pharmaceutical Design 10 (2010): 1510-1521.
  7. Vallon V and Thomson SC. “Diabetes mellitus: Cardiovascular and renal benefits of SGLT2 inhibition: insights from CAN-VAS”. Nature Reviews Nephrology9 (2017): 517-518.
  8. Wang J and Xu Y. “Letter by Wang and Xu Regarding Article, "Age at Diagnosis of Type 2 Diabetes Mellitus and Associations With Cardiovascular and Mortality Risks". Circulation 16 (2019): e722-e723.
  9. Strain W D and Paldánius PM. “Diabetes, cardiovascular disease and the microcirculation”. Cardiovascular Diabetology 1 (2018): 57.
  10. Petrie JR., et al. “Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Vascular Mechanisms”. Canadian Journal of Cardiology5 (2018): 575-584.
  11. Wu L and Gunton J E. “The Changing Landscape of Pharmaco-therapy for Diabetes Mellitus: A Review of Cardiovascular Outcomes”. International Journal of Molecular Sciences23 (2019): 5853.
  12. M Kosiborod., et al. “Rates of myocardial infarction and stroke in patients initiating treatment with SGLT2-inhibitors versus other glucose-lowering agents in real-world clinical practice: Results from the CVD-REAL study”. Diabetes, Obesity and Metabolism8 (2018): 1983-1987.
  13. C Chandramouli., et al. “Association of obesity with heart failure outcomes in 11 Asian regions: A cohort study”. PLoS Medicine9 (2019): e1002916.
  14. K Iglay., et al. “Prevalence and co-prevalence of comorbidities among patients with type 2 diabetes mellitus”. Current Medical Research and Opinion 7 (2016): 1243-1252.
  15. M Kosiborod., et al. “Lower Risk of Heart Failure and Death in Patients Initiated on Sodium-Glucose Cotransporter-2 Inhibitors Versus Other Glucose-Lowering Drugs: The CVD-REAL Study (Comparative Effectiveness of Cardiovascular Outcomes in New Users of Sodium-Glucose Cotransporter-2 Inhibitors)”. Circulation3 (2017): 249-259.
  16. M A Cavender., et al. “SGLT-2 Inhibitors and Cardiovascular Risk: An Analysis of CVD-REAL”. Journal of the American College of Cardiology 22 (2018): 2497-2506.
  17. Y Hayashizaki-Someya., et al. “Ipragliflozin, an SGLT2 inhibitor, exhibits a prophylactic effect on hepatic steatosis and fibrosis induced by choline-deficient I-amino acid-defined diet in rats”. European Journal of Pharmacology 754 (2015): 19-24.
  18. A Koutsovasilis., et al. “Effectiveness of dapagliflozin in nonalcoholic fatty liver disease in type 2 diabetes patients compared to sitagliptin and pioglitazone”. EASD Meeting. Abstract, 11-15 September 2017, Lis-bon, Portugal.
  19. H Tobita., et al. “Effects of Dapagliflozin on Body Composition and Liver Tests in Patients with Nonalcoholic Steatohepatitis Associated with Type 2 Diabetes Mellitus: A Prospective, Open-label, Uncontrolled Study”. Current Therapeutic Research 7 (2017): 13-19.
  20. S D Wiviott., et al. “The design and rationale for the Dapagliflozin Effect on Cardiovascular Events (DECLARE)-TIMI 58 Trial”. American Heart Journal 200 (2018): 83-89.
  21. , et al. “Effects of dapagliflozin on development and progression of kidney disease in patients with type 2 diabetes: an analysis from the DECLARE-TIMI 58 randomised trial”. Lancet Diabetes and Endocrinology 7.8 (2019): 606-617.
  22. Y Kluger., et al. “Cardiorenal Outcomes in the CANVAS, DECLARE-TIMI 58, and EMPA-REG OUTCOME Trials: A Systematic Review”. Reviews in Cardiovascular Medicine2 (2019): 41-49.
  23. I Raz., et al. “DECLARE-TIMI 58: Participants' baseline characteristics”. Diabetes, Obesity and Metabolism5 (2018): 1102-1110.
  24. Sokolova L K. “Cukrovij dіabet і kardіovaskulyarnij rizik: vibіr optimal'noї cukroznizhuyuchoї terapії”. Zdorov’ya Ukraїni4 (2019): 275-280.
  25. M E Nassif., et al. “Dapagliflozin effects on biomarkers, symptoms, and functional status in patients with heart failure with reduced ejection fraction: the DEFINEHF trial”. Circulation 140 (2019): 1463-1476.
  26. Williams DM and Evans M. “Dapagliflozin for Heart Failure with Preserved Ejection Fraction: Will the DELIVER Study Deliver?” Diabetes Therapy 11 (2020): 2207-2219.
  27. F Savira., et al. “Cost-effectiveness of dapagliflozin in chronic heart failure: an analysis from the Australian healthcare perspective”. European Journal of Preventive Cardiology (2020).
  28. C Arnott., et al. “Sodium-Glucose Cotransporter 2 Inhibition for the Prevention of Cardiovascular Events in Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis”. Journal of the American Heart Association3 (2020): e014908.


Citation: Kravchun PP., et al. “Experience of Using Sodium-dependent Glucose Cotransporter Type 2 Inhibitors in Comorbid Patients in Real Clinical Practice". Acta Scientific Gastrointestinal Disorders 6.3 (2023): 14-20.


Copyright: © 2022 Kravchun PP., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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