Oral GLP-1 RA (Semaglutide) Versus SGLT 2 Inhibitors in Patients with Type 2 Diabetes Mellitus Uncontrolled on Metformin - A Clinical Observational Prospective Study

Abstract

Study Design & Methods:

Over the study duration of 6 months, 65 patients were enrolled into each group, one on oral Semaglutide(GLP-1RA) and the other on SGLT-2 inhibitors with ongoing background treatments eg; metformin.

The Key end point of the study was to compare the percentage reduction in HbA1c from baseline to month 6 (Primary) and Bodyweight, BMI, BP, Total Cholesterol, LDL ,Serum Creatinine, eGFR (Secondary)

Results:

Fifty Nine (91%) patients on GLP-1RA group And Sixty Three (97%) patients on SGLT-2 Inhibitor group and completed the study.

Mean reduction in HbA1C with Oral Semaglutide over a period of 6 months was 1.9 ± 1.0. (p<0.001).

Mean reduction in HbA1C with SGLT-2i group over a period of 6 months was 1.58 ± 0.77 %. (p <0.001).

It was found that the mean reduction in HbA1c was more with GLP-1 RA than SGLT2 inhibitor in all the categories of HbA1C.This was statistically significant proving superiority of Oral Semaglutide.

Conclusion:

Oral Semaglutide was superior than SGLT-2 Inhibitors in reducing HbA1c at 6 month in patients with type 2 diabetes uncontrolled on Metformin. Body weight was also significantly reduced in both the groups Mean reduction in BMI with GLP-1 RA was 2.47 ± 2.6. (p <0.001) and Mean reduction in BMI with SGLT-2i was 1.72 ± 1.1 (p <0.001).

Mean reduction in SBP and DBP between GLP-1RA and SGLT-2 Inhibitors were 6.4mmHg/6mmHg and 3.6mmHg/4.7mmHg respectively.

Mean reduction in Total cholesterol between both groups was 72.8 mg/dl and 66.1mg/dl respectively.

Oral semaglutide was well tolerated within the established safety profile of GLP-1 receptor agonist.