Original Research
Saturday, October 12, 2024
11:30 AM–01:00 PM
Abstract
Introduction:
The sodium-glucose cotransporter 2 inhibitor (SGLT2i), dapagliflozin, has been shown to reduce the risk of cardiovascular and renal outcomes. However, there is limited data regarding its role in preventing microvascular complications.
Research Question or Hypothesis:
This study aims to evaluate the risk of developing ocular outcomes, including diabetic retinopathy (DR), open-angle glaucoma (OAG), and visual loss, among patients with type 2 diabetes mellitus (T2DM) who are treated with dapagliflozin compared to those receiving other hypoglycemic agents.
Study Design:
The study design was an observational, retrospective, multi-center cohort study.
Methods:
We extracted data from Taipei Medical University Clinical Research Database from 2016 to 2020, including a medical center and two regional hospitals in Taiwan. Criteria for selecting the subjects were as follows: newly diagnosed T2DM within 5 years, and renal function with estimated glomerular filtration rate above 45 ml/min/m2. Those with a history of DR, OAG or visual loss were excluded. There were 23,948 eligible adults identified. Using 1:1 propensity score matching (PSM), 2,170 SGLT2i users and 2,170 non-SGLT2i users were identified. The primary outcome was a composite of the incidence of DR, OAG, or visual loss.
Results: After 1:1 PSM, SGLT2i users developed significantly lower incident DR, OAG or visual loss, compared with non-SGLT2i users (2.67% vs 3.96%; hazard ratio [HR], 0.67; 95% confidence interval [CI], 0.48 to 0.94, p=0.019 after 1-year follow-up; 3.5% vs 4.79%; HR, 0.73; 95% CI, 0.54 to 0.98, p=0.037 after 2-year follow-up).
Conclusion:
In this study, dapagliflozin demonstrated a significant protective effect on the incidence of DR, OAG, or visual loss in patients with newly diagnosed T2DM within five years during the two-year follow-up. Further investigation into real-world clinical data should focus on the protective effects of diabetic ocular complications among different SGLT2is.
Presenting Author
Jo-Hsin Chen MSWan Fang Hospital, Taipei Medical University
Authors
Jin-Hua Chen Dr
College of Management, Taipei Medical University
Chun-Mei Hsueh Dr
Taipei Medical University Hospital, Taipei Medical University
Fei-Hung Hung Dr
Health Data Analytics and Statistics Center
Shu-Fen Liao Dr
Taipei Municipal Wan Fang Hospital, Taipei Medical University
Gregory Y. H. Lip Dr
Liverpool John Moores University and Liverpool Heart & Chest Hospital
Yu-Ting Wang PharmD
Department of Pharmacy
Jong-Shiuan Yeh Dr
Taipei Municipal Wan-Fang Hospital