Beneficials Effects of Canagliflozin in a Weight-Centered Management in Patients with Type 2 Diabetes Mellitus in Real Practice

Abstract

Objective: Evaluate the real-world efficacy and safety of canagliflozin in patients with type 2 diabetes mellitus (T2DM), associated to a weight-loss intensive lifestyle intervention program (WLIP), to achieve weight loss greater than 5% at 12 months.Methods: Retrospective review of patients with T2DM included in a WLIP, who were prescribed canagliflozin from June 2015 to December 2016 at four endocrinology clinics in the south of Spain within routine clinical practice context. Changes during 12 months in anthropometric variables, HbA1c, uric acid and adverse events were assessed.Results: 201 patients with T2DM (45.8% women, 60.3 ± 9.4 years old and BMI: 34.9 ± 8.7 kg/m2) were studied. Patients treated with canagliflozin lost an average weight and reduced an average of waist circumference of -4.0 ± 4.2 kg and -3.2 ± 8.4 cm, -5.4 ± 5.7 kg and -4.9 ± 9.9 cm and -5.3 ± 8.0 kg and -7.0 ± 14.6 cm, achieving weight loss greater than 5%: 29.0%, 47.9% and 42.7% of patients at 3, 6 and 12 months, respectively. HbA1c levels were average reduced by -1.2%, -1.3% and -1.3% and 68.8% reached an HbA1c level ≤ 7% at 12 months. 17.9% (36 patients) experienced mild adverse events and canagliflozin treatment was suspended in 23 patients (11.4%).Conclusion: The addition of canagliflozin to the treatment of overweight or obese patients with T2DM, as a complement of a weight-loss intensive lifestyle intervention, was associated with improvement in body weight and glycemic control with relative mild adverse events.