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Efects o Dapagliozin, an SGLT2Inhibitor, on HbA1c, o!" #eight,
an! H"pogl"ce$ia %is& in 'atients#ith T"pe 2 Diabetes Ina!e()atel"
*ontrolle! on 'ioglitazone
+onotherap"
Annis %a&h$aati
'e$bi$bing- !r %. oo 'ra$ono, Sp'D/0E+D
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I!entitas )rnal
)!)l - Efects o Dapagliozin, an SGLT2Inhibitor, on HbA1c, o!" #eight, an!H"pogl"ce$ia %is& in 'atients #ith T"pe 2
Diabetes Ina!e()atel" *ontrolle! on'ioglitazone +onotherap"
'en)lis- )lio rosenstoc& et al
')bli&asi - Diabetes care, ol)$e 34, 5)l"2612
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I7T%8D9*TI87
SGLT2 inhibitor : hipergl"ce$ia :in!)ce $il! os$otic !i)resis an! ;)rinar" e
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'ioglitazone loers gl)cose b"
enhancing ins)lin sensitiit". Saet" concerns o )i! retention,
eight gain, *H, bone ract)res,
bla!!er cancer has li$ite! its )se assecon! line therap" hen $etor$inis not tolerate! or as triple oraltherap"
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Dapagliozin gl)cos)ria !i)resis= caloric loss concern o eightgain = )i! retentionBe!e$a.
The ai$ to e
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S)b5ects
Inclusion Criteria 1 ".o ith asting */pepti!e 1.6 ngB$L an! +I
F 4.6
2 )l" 266 an! )l" 266. The st)!" too&place
at 164 sites in Argentina, *ana!a,In!ia, +e
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+etho!s
ran!o$ize!, !o)ble blin!, placebo/controlle!, parallel gro)p to e
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Treat$ent/naie patients or thosereceiing $etor$in, S9, or T?D entere! a
16/ee& pioglitazone !ose/opti$izationperio! ith onl" pioglitazone.
The" ere ran!o$ize!, along ith patientspreio)sl" receiing pioglitazone 36 $g,
to ee&s o !o)ble/blin! !apagliozin4$g >n J 11@ or 16$g >n J 16@ orplacebo >n J 13@ eer" !a" pl)s open/label pioglitazone.
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'ri$ar" en! point changes ro$
baseline in HbA1c, 'G, ''G, bo!"eight at ee& 2 )sing A7*8A$o!el
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7/24/2019 Effects of Dapagliflozin, an SGLT2.ppt
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%es)lt
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Disc)ssion
In this st)!", the a!!ition o!apagliozin to pioglitazone loere!HbA1c an! eight gain in T2D+
ina!e()atel" controlle! onpioglitazone alone.
Dapagliozin acts in the &i!ne" b"
inhibiting the reabsorption o gl)cose: 'G , : ''G
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The gl)cos)ria in!)ce! b" SGLT/2inhibition s)specte! lea!ing toh"pogl"ce$ia, 9TIs, an! genital
inections.
H"pogl"ce$ia eents ere rare inthis st)!".
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*onsistent ith preio)s reports genital inections ere higher in patientson !apagliozin than on placebo.
7one o these genital inections ereserio)s, an! all respon!e! toanti$icrobial treat$ent.
Dapagliozin, acting as a $il! !i)retic,$itigate the )i! retaining efects opioglitazone
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*oncl)sion
The !irect re$oal o gl)cose b"!apagliozin co$ple$ents theins)lin/sensitizing action o
pioglitazone
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*ritical Appraisal
Are the results Valid
1. #as the assign$ent o patients to treat$ents ran!o$ize!K An!
as the ran!o$ization list conceale!K "es
2. #as ollo/)p o patients s)Ccientl" long an! co$pleteK "es3. #ere patients anal"ze! in the gro)ps hich the" ere ran!o$ize!K
"es
. #ere patients an! clinicians &ept blin!M to treat$entK "es
4. #ere the gro)ps treate! e()all", apart ro$ the e
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Are the ali! res)lts o thisran!o$ize! st)!" i$portantK
1. #hat is the $agnit)!e o the treat$ent efectK
7o !ata
2. Ho precise is this esti$ate o the treat$ent
efectK 7o !ata
A th li! i t t
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Are these ali!, i$portantres)lts applicable to o)r
patientK1. Is o)r patient so !iferent ro$ those in thest)!" that its res)lts cannot appl"K 7o
2. Is the treat$ent easible in o)r settingK Oes
3. #hat are o)r patientPs potential beneQts an!
har$s or$ the therap"K
eneQt- potential co$bination that balancesell the beneQts an! ris&s o therap" or T2D+.
Har$ - Has not been proe! as gol! stan!ar!therap"
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Than& "o)