Addition of SGLT2 inhibitors in type 2 diabetes is associated with persistent and significant weight loss: a real-world study from Eastern India

Background: The obesity pandemic is triggering the tsunami of type 2 diabetes mellitus (T2DM) worldwide. Sodium-glucose transport protein 2 inhibitors (SGLT2i) have demonstrated weight loss in clinical trials. This retrospective study aims to look at long-term effects on body weight, body mass index (BMI), and glycemic control (HbA1c), when SGLT2i are added to existing glucose-lowering drug (GLD), in real-world settings. Methods: The hospital database of endocrinology outpatient was searched in whom one of the three SGLT2i was prescribed over and above the preexisting anti-diabetic regime. Anthropometric parameters, HbA1c, and blood pressure data were captured for analysis at the onset of the therapy and at the last visit. Subjects with interruption or termination of therapy including hospitalization or non-availability of requisite data were excluded. Results: Forty-five of 417 subjects were lost to follow-up. The subjects of the three groups of SGLT2i (viz canagliflozin, dapagliflozin, empagliflozin) were fairly matched with respect to age, height, body weight, BMI, blood pressure, and HbA1c. All the groups achieved a mean weight loss of 1 kg over an average of 12 months of therapy. Decrease in weight, BMI, and HbA1c were statistically significant. There was weight gain in 16.93%, less than 5% weight loss in 35.21%, 5–10% weight loss in 11.55%, more than 10% weight loss in 13.17%, while no change in 23.11%. Nearly 25% of subjects had more than 5% weight loss irrespective of accompanying drugs, suggesting the benefits of SGLT2i across the spectrum of T2DM. Conclusions: The addition of SGLT2i causes persistent and significant weight loss along with improvement in glycemic control, independent of background GLD and duration of diabetes. Weight loss was not so significant but HbA1c reduction from baseline and blood pressure changes was more as compared to previous trials with SGLT2i.