Clinical use of sodium-glucose co-transporter-2 inhibitors in Chinese patients with type 2 diabetes mellitus

INTRODUCTION Type 2 diabetes mellitus (T2DM), the tenth leading cause of death in Hong Kong, has a prevalence of approximately 10%. Sodium-glucose co-transporter-2 (SGLT2) inhibitors lower glycated haemoglobin (HbA1c) levels in T2DM patients via a non-insulin-dependent mechanism of action, but real-world data is limited, particularly for Chinese patients. METHODS A retrospective single-centre study was performed among Chinese patients with T2DM who were prescribed SGLT2 inhibitor therapy in Hong Kong. Changes in HbA1c levels, body weight, systolic and diastolic blood pressure, estimated glomerular filtration rate (eGFR), lipid profiles and adverse events were observed for patients who completed at least one follow-up visit during the study period. RESULTS Overall, 100 patients were included, and 53 patients attended an additional final visit. By the final visit, SGLT2 inhibitor therapy had significantly decreased HbA1c levels (change [Delta] 0.31%, 95% confidence interval [CI] -0.11% to -0.51%, p < 0.001), body weight (Delta -4.59 kg, 95% CI -3.75 to -5.54 kg, p < 0.001) and systolic blood pressure (Delta -5.72 mmHg, 95% CI -1.72 to -9.72 mmHg, p < 0.001) from baseline. No significant change in eGFR or lipid profiles was observed, except for a significant reduction in high-density lipoprotein cholesterol (Delta -0.09 mmol/L, 95% CI -0.16 to -0.02 mmol/L, p < 0.05). Adverse events were consistent with previous reports for SGLT2 inhibitors, apart from appetite loss associated with canagliflozin. CONCLUSION The real-world efficacy and safety profile of SGLT2 inhibitors in Chinese patients was comparable to that reported in Phase III clinical trials, with the exception of appetite loss among patients who received canagliflozin.