Cover Image

The effect of dapagliflozin on clinical, metabolic and renal parameters in type 2 diabetic patient in University of Malaya Medical Centre: A single centre experience / Ho Hee Kheen

As Asian patients with type 2 diabetes mellitus (T2DM) have significant beta cell dysfunction and increased visceral adiposity, we hypothesize that sodium glucose cotransporter inhibitors which acts independent from insulin dependent mechanisms, are effective in a multi ethnic T2DM population in rea...

Full description

Saved in:
Bibliographic Details
Main Author: Ho , Hee Kheen
Format: Thesis
Published: 2017
Subjects:
R Medicine (General)
RC Internal medicine
Online Access:http://studentsrepo.um.edu.my/8803/7/hee_kheen.pdf
http://studentsrepo.um.edu.my/8803/
Tags: Add Tag
No Tags, Be the first to tag this record!
id my.um.stud.8803
record_format eprints
spelling my.um.stud.88032020-06-08T18:27:11Z The effect of dapagliflozin on clinical, metabolic and renal parameters in type 2 diabetic patient in University of Malaya Medical Centre: A single centre experience / Ho Hee Kheen Ho , Hee Kheen R Medicine (General) RC Internal medicine As Asian patients with type 2 diabetes mellitus (T2DM) have significant beta cell dysfunction and increased visceral adiposity, we hypothesize that sodium glucose cotransporter inhibitors which acts independent from insulin dependent mechanisms, are effective in a multi ethnic T2DM population in real-world setting. A retrospective T2DM cohort (N=ll 0) treated with dapagliflozin for months was identified from the electronic pharmacy database. Estimated glomerular filtration rate (eGFR) was calculated using CKD-EPI 2009 equation. Missing laboratory values were imputed utilizing the "last observation-carried-forward" method. The 6- and 12-month postinterventional differences in biochemical profiles were examined using linear mixed-effects model or Friedman test. The mean age [±standard deviation] and disease duration [± standard deviation] were 56.2±9.5 and 14.8±8.0 years, respectively; mean HbA1c [±S.D.] was 70±14 rnmoVmol (8.6± 1.3%), 43.6% were men, and 22.7% had existing cardiovascular disease. The proportions of participants based on ethnicity were Malay 31.8%, Chinese 29 .I% and Indian 33 .6%. At 12 months, there was a significant decline in HbA1c (Mdndifference -10 mmol/mol [- 0.9%], 95% CI -13 to -8 mmoVmol [1.2 to -0.7%], P<O.OOI), systolic blood pressure (SBP, Meandiffcrence -4.1 mmHg, 95% Cl -7.6 to -0.7,?=0.013), and body weight (Meandaffereoce-2.01 kg, 95% CI -2.92 to -1.1 0, P=O.O 13). There are also significant improvements in urinary albumin: creatinine ratio (Mdndiffcrcnce -0.45 mg/mmol, 95% CI -1.15 to < -0.001, P=O.O 19), square-root transformed eGFR (P=0.024), and the proportions of patients attaining HbAtc <7% (P<O.OOl) or SBP <140 mmHg (P=0.007. Suboptimally-controlled multi-ethnic Asians with T2DM showed substantial improvements in metabolic and renal parameters with dapagliflozin over a year. 2017-11 Thesis NonPeerReviewed application/pdf http://studentsrepo.um.edu.my/8803/7/hee_kheen.pdf Ho , Hee Kheen (2017) The effect of dapagliflozin on clinical, metabolic and renal parameters in type 2 diabetic patient in University of Malaya Medical Centre: A single centre experience / Ho Hee Kheen. Masters thesis, University of Malaya. http://studentsrepo.um.edu.my/8803/
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Student Repository
url_provider http://studentsrepo.um.edu.my/
topic R Medicine (General)
RC Internal medicine
spellingShingle R Medicine (General)
RC Internal medicine
Ho , Hee Kheen
The effect of dapagliflozin on clinical, metabolic and renal parameters in type 2 diabetic patient in University of Malaya Medical Centre: A single centre experience / Ho Hee Kheen
description As Asian patients with type 2 diabetes mellitus (T2DM) have significant beta cell dysfunction and increased visceral adiposity, we hypothesize that sodium glucose cotransporter inhibitors which acts independent from insulin dependent mechanisms, are effective in a multi ethnic T2DM population in real-world setting. A retrospective T2DM cohort (N=ll 0) treated with dapagliflozin for months was identified from the electronic pharmacy database. Estimated glomerular filtration rate (eGFR) was calculated using CKD-EPI 2009 equation. Missing laboratory values were imputed utilizing the "last observation-carried-forward" method. The 6- and 12-month postinterventional differences in biochemical profiles were examined using linear mixed-effects model or Friedman test. The mean age [±standard deviation] and disease duration [± standard deviation] were 56.2±9.5 and 14.8±8.0 years, respectively; mean HbA1c [±S.D.] was 70±14 rnmoVmol (8.6± 1.3%), 43.6% were men, and 22.7% had existing cardiovascular disease. The proportions of participants based on ethnicity were Malay 31.8%, Chinese 29 .I% and Indian 33 .6%. At 12 months, there was a significant decline in HbA1c (Mdndifference -10 mmol/mol [- 0.9%], 95% CI -13 to -8 mmoVmol [1.2 to -0.7%], P<O.OOI), systolic blood pressure (SBP, Meandiffcrence -4.1 mmHg, 95% Cl -7.6 to -0.7,?=0.013), and body weight (Meandaffereoce-2.01 kg, 95% CI -2.92 to -1.1 0, P=O.O 13). There are also significant improvements in urinary albumin: creatinine ratio (Mdndiffcrcnce -0.45 mg/mmol, 95% CI -1.15 to < -0.001, P=O.O 19), square-root transformed eGFR (P=0.024), and the proportions of patients attaining HbAtc <7% (P<O.OOl) or SBP <140 mmHg (P=0.007. Suboptimally-controlled multi-ethnic Asians with T2DM showed substantial improvements in metabolic and renal parameters with dapagliflozin over a year.
format Thesis
author Ho , Hee Kheen
author_facet Ho , Hee Kheen
author_sort Ho , Hee Kheen
title The effect of dapagliflozin on clinical, metabolic and renal parameters in type 2 diabetic patient in University of Malaya Medical Centre: A single centre experience / Ho Hee Kheen
title_short The effect of dapagliflozin on clinical, metabolic and renal parameters in type 2 diabetic patient in University of Malaya Medical Centre: A single centre experience / Ho Hee Kheen
title_full The effect of dapagliflozin on clinical, metabolic and renal parameters in type 2 diabetic patient in University of Malaya Medical Centre: A single centre experience / Ho Hee Kheen
title_fullStr The effect of dapagliflozin on clinical, metabolic and renal parameters in type 2 diabetic patient in University of Malaya Medical Centre: A single centre experience / Ho Hee Kheen
title_full_unstemmed The effect of dapagliflozin on clinical, metabolic and renal parameters in type 2 diabetic patient in University of Malaya Medical Centre: A single centre experience / Ho Hee Kheen
title_sort effect of dapagliflozin on clinical, metabolic and renal parameters in type 2 diabetic patient in university of malaya medical centre: a single centre experience / ho hee kheen
publishDate 2017
url http://studentsrepo.um.edu.my/8803/7/hee_kheen.pdf
http://studentsrepo.um.edu.my/8803/
_version_ 1738506188119605248
score 13.211869

Similar Items