Evaluating the Safety and Efficacy of Sodium-Glucose Co-transporter 2 Inhibitors in Subjects with Prediabetes: A Protocol for a Randomized Controlled Trial.

IF 3.8 3区 医学 Q2 Medicine Diabetes Therapy Pub Date : 2024-05-01 Epub Date: 2024-03-18 DOI:10.1007/s13300-024-01560-3
Xiaxuan Zhu, Li Xia, Deshan Yin, Jin Yang, Rui Wei
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Abstract

Introduction: Prediabetes is a state of subclinical glycemic impairment, bridging normal glucose tolerance and diabetes. Globally, over 30% of individuals exhibit prediabetic conditions, with a significant proportion progressing to diabetes. Prediabetes augments risks of various diseases including cardiovascular and kidney disease. While interventions like lifestyle changes have shown promise in diabetes prevention, their long-term sustainability is challenging. Alternative pharmacological treatments, such as acarbose and metformin, have demonstrated efficacy in certain populations. Sodium-glucose co-transporter 2 inhibitors, a novel class of glucose-lowering agents, have shown potential benefits for heart and kidney health in patients with diabetes. This research aims to evaluate the effectiveness and safety of dapagliflozin in individuals with prediabetes, elucidating its potential role in diabetes prevention strategies.

Research design and methods: This prospective trial is being conducted at Peking University Third Hospital. A total of 240 participants with prediabetes will be enrolled and randomly divided into two groups: one receiving dapagliflozin (10 mg/day) with lifestyle education, and the other with lifestyle education alone over a 12-week duration (with male/female = 1:1 in each group). Anthropometric, clinical and laboratory tests, including body mass index, waist circumference, fasting blood glucose, oral glucose tolerance test, insulin, lipid profile, liver and kidney function, sperm quality, will be conducted at the onset and conclusion of the trial. For adherence monitoring, participants will receive phone follow-ups at week 4 and week 8. The primary outcome is the change in 2-h plasma glucose during an oral glucose tolerance test over the study duration. Secondary outcomes encompass changes in various health metrics, including body mass index, lipid profiles, and liver function.

Planned outcomes: The proposed study is set to refine diabetes prevention strategies on the basis of its potential benefits observed in patients with diabetes.

Conclusions: This will be the first randomized controlled trial to evaluate the safety and effectiveness of sodium-glucose co-transporter 2 inhibitors compared with lifestyle education for individuals with prediabetes.

Trial registration: ClinicalTrials.gov identifier NCT05914857 (registered 24 July 2023).

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评估钠-葡萄糖协同转运体 2 抑制剂对糖尿病前期患者的安全性和有效性:随机对照试验方案》。
导言糖尿病前期是一种亚临床血糖损害状态,是正常糖耐量和糖尿病之间的桥梁。在全球范围内,超过 30% 的人表现出糖尿病前期症状,其中很大一部分会发展为糖尿病。糖尿病前期会增加罹患各种疾病的风险,包括心血管疾病和肾脏疾病。虽然改变生活方式等干预措施有望预防糖尿病,但其长期可持续性却面临挑战。阿卡波糖和二甲双胍等替代药物治疗已在某些人群中显示出疗效。钠-葡萄糖协同转运体 2 抑制剂是一类新型降糖药物,已显示出对糖尿病患者心脏和肾脏健康的潜在益处。这项研究旨在评估达帕格列净对糖尿病前期患者的有效性和安全性,阐明其在糖尿病预防策略中的潜在作用:这项前瞻性试验在北京大学第三医院进行。总共 240 名糖尿病前期患者将被随机分为两组:一组接受达帕格列净(10 毫克/天)和生活方式教育,另一组仅接受生活方式教育,为期 12 周(每组男女比例为 1:1)。试验开始和结束时将进行人体测量、临床和实验室检查,包括体重指数、腰围、空腹血糖、口服葡萄糖耐量试验、胰岛素、血脂、肝肾功能和精子质量。在坚持监测方面,参与者将在第 4 周和第 8 周接受电话随访。主要结果是研究期间口服葡萄糖耐量试验中 2 小时血浆葡萄糖的变化。次要结果包括各种健康指标的变化,包括体重指数、血脂状况和肝功能:拟议的研究将根据糖尿病患者观察到的潜在益处完善糖尿病预防策略:这将是首个评估钠-葡萄糖协同转运体 2 抑制剂与生活方式教育对糖尿病前期患者的安全性和有效性的随机对照试验:试验注册:ClinicalTrials.gov标识符NCT05914857(2023年7月24日注册)。
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来源期刊
Diabetes Therapy
Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
6.90
自引率
7.90%
发文量
130
审稿时长
6 weeks
期刊介绍: Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
期刊最新文献
12-Month Time in Tight Range Improvement with Advanced Hybrid-Closed Loop System in Adults with Type 1 Diabetes. Rationale and Design of the Study to Investigate the Metabolic Action of Imeglimin on Patients with Type 2 Diabetes Mellitus (SISIMAI). Sodium-Glucose Co-transporter-2 Inhibitors in Type 1 Diabetes Mellitus: The Framework for Recommendations for Their Potential Use. Current Perspectives in Pre- and Diabetic Peripheral Neuropathy Diagnosis and Management: An Expert Statement for the Gulf Region. Switching from Premixed Insulin to Insulin Degludec/Insulin Aspart for the Management of Type 2 Diabetes Mellitus: Implications of a Real-World Study on Insulin Degludec Dosing.
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