A Real-world Comparative Analysis of DPP-۴ Inhibitors Versus SGLT۲ Inhibitors in Type ۲ Diabetes Mellitus

Background: Diabetes has steadily increased in India over the last three decades, with ۷۷ million people having diabetes as of ۲۰۱۹, which is expected to rise to ۱۳۴ million by ۲۰۴۵. Over ۹۰ % of these cases are of type ۲ diabetes. The newer antidiabetics like dipeptidyl peptidase IV (DPP-IV) inhibitors and sodium-glucose transporter-۲ (SGLT-۲) inhibitors are prescribed nowadays in type ۲ diabetic patients. However, the relative efficacy and safety of these two new drug groups are unknown.  Objectives: We conducted this study to evaluate the efficacy and safety of DPP-IV inhibitors and SGLT-۲ inhibitors as add-on therapies in type ۲ diabetic patients attending a tertiary care teaching hospital.  Methods: This was a prospective, observational, comparative study conducted at GCS hospital, Ahmedabad, India, from November ۲۰۲۰ to October ۲۰۲۲.  Results: In this study, ۱۲۵ patients of either gender were enrolled and analysed. Of the ۱۲۵ patients, ۸۲ have been prescribed DPP-IV inhibitors (۶۵.۶%), and ۴۳ were prescribed SGLT-۲ inhibitors (۳۴.۴ %). SGLT-۲ inhibitors had a more substantial decrease in HbA۱c than DPP-IV inhibitors at weeks ۱۲ (-۱.۱۳±۱.۳۳ vs -۰.۳۹±۱.۴۰, P<۰.۰۵) and ۲۴ (-۱.۸۷±۱.۷۴ vs -۱.۰۷±۱.۵۸, P<۰.۰۵). The total number of adverse events was lower in the DPP-IV inhibitor group than in the SGLT ۲ inhibitor group (۱۸.۳% vs ۴۶.۵%). Urinary tract infection was the most common adverse event in the SGLT-۲ inhibitor group. While in the DPP-IV inhibitor group, gastrointestinal adverse events were common.  Conclusion: Though SGLT-۲ inhibitors have shown better efficacy outcomes, their possible adverse drug reactions should be kept in mind by physicians.

کلیدواژه ها:

Comparative study ، Dipeptidyl peptidase IV inhibitors (DPP-IV) ، Sodium-Glucose transporter ۲ inhibitors