Oral Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2017

SGLT2 inhibitors versus GLP-1 analogues – comparison of efficacy and sustainability; an Australian DINGO (Diabetes Informatics Group) multicentre study of over 1,000 class initiations in private endocrine practice (#109)

David M Hoffman 1 2 , N Wah Cheung 1 , Tony Roberts 3 , David Darnelle 4 , Anthony F Morrow 1 , Jerry R Greenfield 1 , Ash Gargya 1 , Tien Ming Hng 1 , Kerri-Ann Chow 1 , Danijela Dravec 1 , Katherine Tonks 1 , Sam Martin 2 , Tim Freeman 2 , Jim Stankovich 5
  1. Endocrinologist, Australian Diabetes Informatics Group (DINGO), Sydney, NSW, Australia
  2. Data Management and Analysis, Software 4 Specialists, Hobart, Tas, Australia
  3. Endocrinologist, Australian Diabetes Informatics Group (DINGO), Adelaide, SA, Australia
  4. Endocrinologist, Australian Diabetes Informatics Group (DINGO), Gosford, NSW, Australia
  5. Health Statistics, Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia

Background: the recent lessening of PBS restrictions on prescribing GLP-1 analogues (GLP1an) and SGLT-2 inhibitors (SGLT2i) in type 2 diabetes (T2D) has seen a proliferation of use  of these relatively new players as add on therapies; clinicians are confronted daily with the conundrum of deciding which of the 2 classes to add first, to maximise patient benefit

Aim: To compare the efficacy and durability of SGLT2i with GLP1an

Method: De-identified data of patients with T2D seen in the 4 year period May 2013 - May 2017 were aggregated from the electronic medical record of endocrinologists using Audit4 (Software 4 Specialists, Australia & NZ). We compared responses to initiation of the 2 classes in respect of HbA1c and weight, and drug duration (start to cease) using Kaplan Meier analysis

Results: Out of a cohort of 5101 patients, 10.8 % had ever started a GLP1an and 15.7 % an SGLT2i. 

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Summary: SGLT2i and GLP1an both significantly reduced weight and HbA1c, SGLT2i having superior weight loss efficacy in the first 18 months, but comparable HbA1c effects; median duration of use of GLP1an was 1.5 years, 0.6 years shorter than SGLT2i

Conclusion: Our data suggests that in real-life conditions, addition of an SGLT2 inhibitor may be an overall more effective and durable treatment than addition of a GLP-1 analogue