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

Abstract

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.