ABSTRACT:
Aim: The aim of this study is to assess the efficacy and safety of dapagliflozin versus vildagliptin in type 2 diabetes patients receiving baseline metformin alone or metformin + sulfonylureas in combination. Method: Our study is a prospective, observational study. Participants (N = 26) with type 2 diabetes aged = 18 years who had inadequate glycaemic control on metformin alone or metformin + sulfonylureas combination received dapagliflozin 10mg or vildagliptin 100mg for 24 weeks. The patients in both groups are compared for outcomes like HbA1c, and hypoglycaemic incidence. Results: At week 24, Dapagliflozin showed superiority in the reduction of HbA1c in combination with metformin (median reduction, -1%; 7.68 at baseline vs 6.6 at 24th week) compared to metformin + vildagliptin (median reduction, -0.5%;7.21 at baseline vs 6.83 at 24th week). Similarly, dapagliflozin showed a higher reduction of HbA1c when given in combination with metformin + sulfonylureas (median reduction, -1.7%; 9.76 at baseline vs 8.0 at 24th week) compared to vildagliptin given in combination with metformin + sulfonylureas (median reduction, -0.8%; 7.35 at baseline vs 6.55 at 24th week). No incidence of hypoglycaemia was observed in both the groups. One patient on metformin + dapagliflozin had a urinary tract infection during the study period. Conclusion: In this real-world study, T2DM patients treated with metformin + dapagliflozin achieved their HbA1c goal more effectively than those treated with metformin + vildagliptin. Similarly, a higher reduction in median HbA1c was observed in patients treated with dapagliflozin, metformin, and sulfonylureas than those on vildagliptin-based triple therapy; however, this was due to their higher baseline HbA1c. In managing T2DM, both medications have been found to be safer in terms of hypoglycaemia incidence.