Poster Presentation The Annual Scientific Meeting of the Australian Diabetes Society and the Australian Diabetes Educators Association 2013

Combined HbA1c and weight reduction is achieved more frequently with add-on dapagliflozin than add-on glipizide in patients with type 2 diabetes inadequately controlled on metformin (#370)

Katja Rohwedder 1 , Michael A Nauck 2 , Santiago Duran-Garcia 3 , Mahdi Hashemi 4 , Shamik J Parikh 5
  1. AstraZeneca, Wedel, Germany
  2. Diabetes Centre, Bad Lauterberg, Germany
  3. Hospital Universitario de Valme, Seville, Spain
  4. AstraZeneca, Mölndal, Sweden
  5. AstraZeneca, Wilmington, Delaware, USA

Sulfonylureas are often used as add-on therapy in type 2 diabetes when metformin fails to maintain glycaemic control, but risks include weight gain and hypoglycaemia. Dapagliflozin (DAPA), an SGLT2 inhibitor, increases urinary glucose excretion and reduces hyperglycaemia independently of insulin secretion or action. This 52- week, double-blind, active-controlled, non-inferiority trial (NCT00660907) randomised patients inadequately controlled on metformin (mean baseline HbA1c, 7.7%) to add-on DAPA (n=406, ≤10mg/d) or glipizide (GLIP; n=408, ≤20 mg/d) and maintained to Week 52 unless hypoglycaemia warranted down-titration. HbA1c noninferiority at Week 52 has been reported. Here, we report the proportion of patients achieving combined HbA1c and weight reduction, and rates of hypoglycaemia. At Week 52, 3-fold more DAPA-treated patients achieved combined HbA1c and weight reduction (66.9%) vs 21.3% of GLIP-treated patients. Proportions achieving HbA1c reduction were 74.7% vs 73.8% and weight reduction were 83.5% vs 26.8% with DAPA vs GLIP, respectively. The distribution of these proportions was significantly different between treatments (Chi2 = 268.6, df = 3, p<0.0001). Hypoglycaemic events were less frequent with DAPA (3.5%) vs GLIP (40.8%). DAPA produced similar glycaemic efficacy to GLIP, but with the benefits of weight loss and low rates of hypoglycaemia.