Canagliflozin improves glycemic control and body weight and reduces insulin doses in patients with type 2 diabetes treated with insulin in real practice

Abstract

Introduction: Canagliflozin is a class of oral anti-diabetic agent with limited real-world experience reported in patients treated with insulin. Objective: The aim of this study was to evaluate effectiveness and safety of the administration of canagliflozin in patients with type 2 diabetes mellitus (T2DM) treated with different insulin regimens. Methods: A retrospective observational study of patients with T2DM treated with insulin who were prescribed canagliflozin from June 2015 to December 2016 at four endocrinology clinics in the South of Spain was designed. 12 months changes in anthropometric variables, glycemic control, insulin doses, anti-diabetic drugs and adverse events were assessed after canagliflozin administration. Results: 92 patients with T2DM treated with insulin (44 women, mean age 61.2 ± 10.0 years old and mean BMI: 35.2 ± 11.2 kg/m 2 ) were studied. Improvement was observed in HbA1c (8.7 ± 1.6 vs. 7.2 ± 0.8%; p <0.01), body weight (92.4 ± 20.9 vs. 87.1 ± 19.5 kg; p <0.01) and waist circumference (112.4 ± 17.0 vs. 105.0 ± 21.7; p: 0.04), with a reduction of insulin doses (57.7 ± 38.9 vs. 35.1 ± 32.5 IU/day, p <0.01) and insulin injections per day (2.1 ± 1.2 vs. 1.1 ± 0.8, p<0.01) after 12 months of canagliflozin administration. 49% of the patients reached HbA1c ≤ 7% and 12 patients (13%) completely suspended treatment with insulin. 15 patients (16.3%) experienced mild adverse events and canagliflozin administration was suspended in 9 patients (9.8%). Conclusions: Canagliflozin administration in patients with T2DM treated with insulin was associated with an improvement in glycemic control and body weight and with a reduction of insulin doses with limited and mild adverse events.