The clinical efficacy, outcomes and quality of life of diabetic disease patients treated with dapagliflozin

Abstract

Introduction: Diabetic kidney disease (DKD) is a leading cause of end-stage renal disease and a common serious complication that affects 1/3rd of type-1 and half of type-2 diabetes mellitus patients. In the early stages of DKD-RAAS blockades (angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers) and antihyperglycemic agents such as sodium-glucose transport protein (SGLT) 2 inhibitors, glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors may help prevent DKD by lowering blood glucose levels and through intrinsic renal protection. SGLT2 inhibitors are a new class of oral antidiabetic drugs, which delay the progression of DKD. Dapagliflozin is a drug of choice when the estimated glomerular filtration rate (eGFR) is 25–75 mL/min/1.73 m2 and urine albumin–creatinine ratio ≥≥30 mg/mmol. Aim and Objectives: The aim of the study was to evaluate the clinical outcomes of dapagliflozin in DKD and to check the complications and quality of life of the patients after treatment. Methodology: It was a prospective observational study conducted for a period of 6 months in a tertiary care hospital. The data were collected from the 49 patients with DKD who underwent treatment with dapagliflozin, after approval of the protocol by the IEC. The statistical analysis was done using SPSS software, V.22.(1) 1. SPSS I. IBM SPSS Statistics Version 22 Statistical Software: Core System Users’ Guide. SPSS Inc. 2014. Results and Discussion: The majority of patients enrolled were males (81.63%) compared to females (18.36%) and most of them were geriatrics > 60 years. The majority of patients received dapagliflozin 10 mg, followed by few patients with 5 mg. The effectiveness of dapagliflozin was observed by statistically significant improvement in serum creatinine (P < 0.05), BUN (P < 0.05), and blood urea (P ≤ 0.05). Clinically significant improvement was observed in eGFR, creatinine clearance, serum sodium, potassium, chlorides, glycated hemoglobin levels, and body mass index (P > 0.05), which was statistically insignificant. Statistically significant improvement in the quality of life (P < 0.001) of patients was observed. Out of 49, two patients reported with UTI which may be a suspected drug-related side effect. Conclusion: The study concludes that dapagliflozin has a positive impact on treating DKD. The overall quality of life of the patients was moderately improved. These outcomes suggest that dapagliflozin may become the main line therapy in patients suffering from DKD.