Effects of Add-on Therapy with Sodium- Glucose Cotransporter 2 Inhibitors on Estimated Glomerular Filtration Rate in Type 2 Diabetic Patients Receiving Renin-Angiotensin System Blockers

Abstract

Objective: To compare changes in estimated glomerular filtration rate (eGFR) in type 2 diabetic patients receiving an add-on therapy with sodium-glucose cotransporter 2 inhibitors (SGLT2 inhibitors) in combination with renin-angiotensin system inhibitors (RAS blockers) compared with those receiving RAS blockers. Methods: This research retrospectively collected data from electronic medical records in Sawanpracharak Hospital. The study recruited 350 patients with type 2 diabetes aged 18 years and over from January 2017 to December 2021. Study group with 175 patients received SGLT2 inhibitors together with RAS blockers. Control group with 175 patients received RAS blockers. Study outcomes were eGFR, hemoglobin A1c, blood pressure, and body weight measured at month 0, 3, 6, and 12. Results: eGFR between the study group and the control group in both females and males were not significantly different. Female was the factor affecting the change in eGFR at P=0.024. Hemoglobin A1c of the two groups was not significantly different. Duration of diabetes and hemoglobin A1c at baseline were factors that affected the change in Hemoglobin A1c at P=0.003 and P<0.001, respectively. Body weights of the two groups were significantly different at P=0.008, with a difference of -1.62 and -0.35 kg in mean body weight per year in the study group and control group, respectively. Baseline body weight was the factor affecting the change in body weight at P<0.001. Conclusions: Patients with type 2 diabetes who received SGLT2 inhibitors with RAS blockers lost more weight than those who received RAS blockers.