SGLT2i reduces risk of new-onset T2DM
A prespecified analysis of the DAPA-HF study presented at the American Diabetes Association’s (ADA’s) 80th Virtual Scientific Sessions showed that the SGLT2 inhibitor dapagliflozin resulted in reduction of onset of T2DM in patients with heart failure with reduced ejection fraction (HFrEF).
DAPA-HF was a phase 3, placebo-controlled, international trial that evaluated dapagliflozin in patients with HFrEF. 4744 Patients with and without T2DM were enrolled and randomized to dapagliflozin or placebo. Treatment with dapagliflozin reduced risk of worsening HF or CV death compared to placebo, regardless of presence or absence of diabetes.
This prespecified analysis examined the effect of dapagliflozin on incidence of T2DM compared to placebo in 2605 participants without T2DM at baseline. 1298 Participants had been assigned to the dapagliflozin group and 1307 to the placebo group.
New-onset T2DM was defined as HbA1c ≥6.5% on two consecutive study visits. Median follow-up was 18.2 months.
157 Participants developed T2DM, of whom 150 had prediabetes at baseline. Dapagliflozin reduced new-onset diabetes by 32% (4.9% developed T2DM in the dapagliflozin group vs. 7.1% in the placebo group). An additional exploratory analysis showed that patients who developed T2DM during the trial had a 70% increase in mortality, after adjustment for baseline characteristics.