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404 Real World Effect of Type 2 Diabetes
Therapies On HbA1c and Weight

peptidyl peptidase-4 (DPP-4) inhibitors, and SGLT-2 Results
inhibitors that not only reduce blood glucose, but can Baseline demographics for HbA1c and weight for
also have a beneficial impact on body weight, com- each treatment group are shown in table one. For all
pared to older agents such as the sulphonylureas, patients, the mean blood pressure was 137/78 mmHg
which are typically associated with weight gain, as and the average lipid profile of patients was; total
is insulin therapy (4,5,6).
cholesterol 4.39mmol/L, triglyceride 2.09mmol/L,
Clinical trials suggest GLP-1 agonists reduce HbA1c LDL 2.34 mmol/L and HDL 1.13mmol/L. There was
by 9-16mmol/mol and weight by 2- 3kg(7), SGLT-2 no significant difference within each class for blood
inhibitors reduce HbA1c by 6-11mmol/mol and weight pressure and lipid profile at any of the time intervals.
2-3kg(8,9) , whilst DPP-4 inhibitors reduce HbA1c by
7-11mmol/mol and have a more weight neutral effect Analysis within each class
(5,10) All therapy groups demonstrated statistically signif-
icant falls in HbA1c, at both 3 and 12 months, when
AIMS compared to baseline (table 2). There were no signif-
This study reviewed the use, in routine clinical prac- icant differences between the individual treatments
tice, of additional glucose lowering agents in a T2DM within each drug class, and there were also no signif-
population attending a hospital based secondary care icant changes in the HbA1c level achieved, between
clinic, rather than a clinical trial setting, to assess the 3 and 12 months, for any drug.
effect of these additional agents on HbA1c and body Of all therapies, only Gliclazide demonstrated a sta-
weight. The null hypothesis is that, there were no dif- tistically significant rise in weight after 12 months (+
ferences between the changes in outcome measures 0.368 Kg.) However there was no significant differ-
between the different therapies used. ence between the sulphonylureas for their effects on
weight, at all time intervals. The DPP4 inhibitors, GLP-
Methods 1 agonists and SGLT-2 inhibitors all demonstrated sig-
Notes for 1,000 consecutive patients attending the nificant weight reductions, at both 3 and 12 months,
Diabetes Clinic at Chelsea and Westminster Hospi- when compared to baseline (table 2). Furthermore,
tal, between January and July 2014, were reviewed. for both Dapagliflozin and Sitagliptin, the weight re-
Of the 628 patients identified as having T2DM, 512 duction after 12 months was significantly more, than
were commenced on additional therapies for gly- at 3 months.
caemic control, and so were included in the study. The results demonstrated no significant difference
Data was collected from the start date of each ther- within the DPP4 inhibitors, GLP-1 agonists and SGLT-
apy and again at 3 and 12 months. All information 2 inhibitors for all of the changes in outcome mea-
was obtained from a review of; paper based medi- sures, at all time intervals.
cal records, Electronic Patient Record, a clinic letter
database and an electronic biochemistry database.
Data collected included; age, sex, HbA1c (mmol/mol), Analysis between each class
glucose, weight (kg), height (m), BMI, blood pressure ANOVA analysis demonstrated that there was no
(mmHg), lipid profile. significant difference between baseline HbA1c levels
for any of the therapies added, however there was a
The mean changes in patient indices were calculated significant difference between the different options,
for; baseline data, change after 3 months and change for baseline weight (p value of 1.258 × 10 11 ). After 3
after 12 months. These results were compared to in- and 12 months, there was no significant difference
dividual agents and between drug classes. between the treatment options, for changes in HbA1c,
The results were analyzed using ANOVA (Analysis however ANOVA showed a significant difference for
of Variance). The means of the change in each re- change in body weight after both 3 (p <0.01 ) and 12
corded variable after 3 and 12 months were analyzed months (p<0.01) for the treatment options Table 1 and
to determine if there were any significant differenc- 2. (Figure 1).
es in outcome between the medications. For those
variables, for which a significant difference was iden-
tified, they underwent further analysis by Unpaired
Student T tests. A p value of <0.05 was used to high-
light significance.

GCDC 2017