Renal Effectiveness and Adverse Outcomes of Sodium-Glucose Cotransporter-2 Inhibitors in Type 2 Diabetes Mellitus: A Real-world Evidence Study at Maharaj Nakhon Si Thammarat Hospital
Abstract
Background: Glycemic control is crucial for reducing microvascular renal complications in patients with type 2 diabetes mellitus (T2DM). While sodium-glucose cotransporter 2 inhibitors (SGLT2i) play a pivotal role in delaying the progression of diabetic kidney disease, real-world evidence regarding their effectiveness and safety in the Thai clinical context remains limited.
Objective: To evaluate the real-world effectiveness of SGLT2i on renal function, UACR, glycemic control, body weight, and the incidence of adverse events in patients with T2DM.
Materials and Methods: This retrospective observational study was conducted at Maharaj Nakhon Si Thammarat Hospital. It included 100 patients with T2DM who had been treated with SGLT2i (54% dapagliflozin, 46% empagliflozin) for more than 3 months between 2021 and 2025. Patients were continuously followed up for a period of 24 months.
Results: The study cohort had a mean age of 68.2 ± 9.7 years and a mean diabetes duration of 10.7 ± 5.2 years. After 24 months of follow-up, HbA1c level decreased by 1.15 ± 1.62%, and body weight decreased by 0.84 ± 3.17 kg. Regarding renal effectiveness, the annual rate of decline in urine albumin-to-creatinine ratio (UACR) was significantly greater in the SGLT2i group compared to the matched non-SGLT2i control group (-463.18 ± 184.79 vs. -187.20 ± 158.83 mg/g/year; P < 0.001). Furthermore, the annual rate of estimated glomerular filtration rate (eGFR) decline was clinically slower in the SGLT2i group than in the control group (-2.12 vs. -3.10 mL/min/1.73 m²/year; P = 0.542). Regarding safety, the overall incidence of adverse events was 23%. Urinary tract infections (12%) and acute kidney injury (7%) were the most common adverse events
Conclusion: In real-world clinical practice, SGLT2i therapy significantly reduces UACR and demonstrates a favorable clinical trend in delaying eGFR decline among Thai diabetes patients, while maintaining a safety profile that is manageable and well-tolerated.
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เนื้อหาและข้อมูลในบทความที่ลงตีพิมพ์ในมหาราชนครศรีธรรมราชเวชสาร ถือเป็นข้อคิดเห็นและความรับผิดชอบของผู้เขียนบทความโดยตรงซึ่งกองบรรณาธิการวารสาร ไม่จำเป็นต้องเห็นด้วย หรือร่วมรับผิดชอบใด ๆ
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในมหาราชนครศรีธรรมราชเวชสาร ถือเป็นลิขสิทธิ์ของมหาราชนครศรีธรรมราชเวชสาร หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่ต่อหรือเพื่อกระทำการใด จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษรจากวารสารมหาราชนครศรีธรรมราชเวชสาร ก่อนเท่านั้น
