Assessing the Effectiveness of Sodium-Glucose-Cotransporter 2 Inhibitors on Renal Protection and Blood Pressure among Iraq Patients with Type 2 Diabetes Mellitus
Samar Ali Mahmood, Entisar J. Al-Mukhtar, Yasameen R. Al-SaffarAbstract
Background:
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a new class of antihyperglycemic drugs with multiple potential benefits.
Objectives:
The study aim was to evaluate the effectiveness of SGLT2i (empagliflozin and dapagliflozin) on the albuminuria, glomerular filtration rate (GFR), and blood pressure in patients with type 2 diabetic nephropathy.
Materials and Methods:
This prospective comparative experiment recruited patients with diabetes and kidney disease who newly started SGLT2i from November 2021 to January 2023 during their visits to Diabetic Center at Murjan Hospital, and a private clinic, Babel, Iraq. The researcher collected two samples from each patient: pre- and 4 months post-SGLT2i therapy to measure glycated hemoglobin (HbA1c), serum uric acid, serum creatinine, and urine output for 24 h, GFR, and albumin-to-creatinine ratio (ACR). Wilcoxon’s signed rank test was used to measure the difference in the parameter levels before and after the SGLT2i treatment.
Results:
One-hundred patients with type 2 diabetes mellitus completed the two measurements: 39 patients taking empagliflozin and 61 taking dapagliflozin. The participants included 47 males and 53 females. Among patients with diabetic nephropathy, SGLT2 inhibitors were associated with positive effects on renal function as they significantly (
Conclusions:
In general, this study showed that both SGLT2i have a significant positive impact on blood glucose control, enhance renal function, and reduce serum uric acid and blood pressure (both systolic and diastolic). However, some low-income patients were unable to afford these medications from private pharmacies. The study findings support the prescribing of SGLT2i for type 2 diabetic patients with chronic kidney disease, hypertension, or hyperuricemia.