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

and not statistically different, between the different between any of the treatment options in this audit,
agents used, suggests that while glucose lowering after 3 and 12 months. This result is combined with
is the main effect we were aiming to achieve, the the fact that there were large ranges for how individ-
additional effects on weight may need further review ual patients responded to all outcome measures for
and consideration. It was not structured to determine all treatments, suggests that it may be more appro-
which therapy should be used first in individual cas- priate to tailor treatment choices towards individual
es. Interestingly though, the baseline BMI and HbA1c patients, to ensure they receive what works best for
in the sulphonylurea group was higher than many them, rather than using these different classes of
of the previous trials when these agents were used drug in a strict set order. There were no side effect
(16,17), with a weight gain, which was not as high as profiles and treatment regimens. The results suggest
typically reported for this group of agents, suggest- that GLP-1 receptor agonists and Dapagliflozin may
ing we should consider them, not just in the very have a role if weight loss is particularly desired.
low BMI group, where we as a unit have historically Revised NICE guidelines which recommend a particu-
thought of them as being more appropriate.
lar order and suggests that the use of GLP-1 receptor
Dapagliflozin caused the greatest loss of weight af- agonists for those with a BMI <35kg/m 2 is at the
ter 3 and 12 months. Sulphonylureas, caused a slight discretion of clinicians do not appear to follow what
rise in weight, although this was not significant, apart has been noted in this audit. (18,19)
from Gliclazide treatment after 12 months. DPP-4 in-
hibitors produced minor falls in weight that were not REFERENCE :
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GCDC 2017