Revitalization of thiazolidinedione the optimum agents to be combined with SGLT 2 inhibitors to optimize glycemic control and reduce cardiovascular mortality: randomized control trial

Authors

  • Ishank P. Gupta Department of Medicine, Government Medical College, Nagpur, Maharashtra, India
  • Pravin U. Shingade Department of Medicine, Government Medical College, Nagpur, Maharashtra, India
  • Sajal Bansal Department of Medicine, Government Medical College, Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20231609

Keywords:

Cardiovascular disease, Dapagliflozin, Mortality, Pioglitazone, Thiazolidinedione, Type 2 diabetes mellitus

Abstract

Background: Type 2 diabetes mellitus (T2DM) significantly increases morbidity and mortality from cardiovascular disease. The present study was conducted to know the effect of thiazolidinedione and SGLT2 inhibitor on glycemic control, blood pressure and lipid profile and effect on cardiovascular mortality in T2DM.

Methods: A total 80 patients of aged ≥40 years with T2DM were included and divided into 4 groups based on ongoing treatment i.e., (lifestyle modification + Tab metformin 500mg BD) + 1) Tab metformin 500mg; 2) Tab dapagliflozin 10mg OD; 3) Tab pioglitazone 15mg OD; 4) Tab pioglitazone 15mg OD + Tab Dapagliflozin 10mg OD.

Results: The change in FBS, PLBS and HbA1C from pre-intervention to post-intervention was highest in the patients with DAPA + pioglitazone group followed by patients with pioglitazone group then the patients with DAPA group and lowest in patients with metformin group. There was a statistically significant difference between them, (p<0.001). The weight reduction was highest in the patients with DAPA 10mg group followed by patients with metformin group, (p<0.001). The change in SBP, DBP and change in lipid profile (triglyceride and cholesterol, LDL and HDL) from pre-intervention to post-intervention was highest in the patients with DAPA+ pioglitazone group. This change was statistically significant (p<0.001).

Conclusions: The combination of pioglitazone and dapagliflozin not only helped in glycemic control but also had reduction in blood pressures, improvement in the lipid profile and caused slight weight reduction. There were no major adverse drug reactions, and no MACE was observed during the study. Hence this combination of pioglitazone and dapagliflozin may reduce the cardiovascular mortality (which needs longer duration study).

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Published

2023-05-29

How to Cite

Gupta, I. P., Shingade, P. U., & Bansal, S. (2023). Revitalization of thiazolidinedione the optimum agents to be combined with SGLT 2 inhibitors to optimize glycemic control and reduce cardiovascular mortality: randomized control trial. International Journal of Research in Medical Sciences, 11(6), 2010–2014. https://doi.org/10.18203/2320-6012.ijrms20231609

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Original Research Articles