Glycemic Control and Safety Profile of Newer Oral Antidiabetic Drugs in Type 2 Diabetes Mellitus
DOI:
https://doi.org/10.62497/irjm.187Keywords:
Type 2 diabetes mellitus, T2DM, oral antidiabetic drugs, glycemic control, SGLT-2 inhibitors, safety profileAbstract
Introduction: Due to poor glycemic control and its complications, type 2 diabetes mellitus (T2DM) is a major global health concern that is associated with a high rate of morbidity and mortality. More modern oral antidiabetic drugs have been introduced, and this has increased the therapeutic options that have better efficacy and safety. Nevertheless, there is limited data on their efficacy and tolerability of them in the local real world.
Materials and Methods: 160 patients with T2DM who were taking newer oral antidiabetic medications participated in this Prospective observational study, which was conducted over a six-month period in a hospital with tertiary care. Glycemic control was assessed using changes in glycated hemoglobin levels and fasting blood glucose (FBG) levels. By documenting the unfavorable follow-up events, the safety was assessed. While independent t-tests and chi-square tests were employed to assess the intergroup and categorical variables, paired t-tests were utilized to compare baseline and follow-up glycemic parameters. Statistically a p-value of less than 0.05 was considered significant.
Results: At baseline, the mean HbA1c was 8.4 ± 1.1%; at follow-up, it was 7.1 ± 0.9% (p < 0.001). Additionally, there was a substantial reduction in FBG levels (p < 0.001). 61.3% of patients had appropriate glycemic control (HbA1c <7%). HbA1c was reduced more by SGLT-2 inhibitors than by DPP-4 inhibitors (p = 0.02). 28.8% of the participants reported complications, the majority of which were minor and controllable.
Conclusion: Newer oral anti-diabetic drugs can manage the level of glycemia and is safe in patients with T2DM, but the SGLT-2 inhibitors have superior effects.
References
Chakravarti HN, Nag A. Efficacy and safety of hydroxychloroquine as add-on therapy in uncontrolled type 2 diabetes patients who were using two oral antidiabetic drugs. Journal of endocrinological investigation. 2021 Mar;44(3):481-92.doi.org/10.1007/s40618-020-01330-5
Piragine E, Petri D, Martelli A, Calderone V, Lucenteforte E. Adherence to oral antidiabetic drugs in patients with type 2 diabetes: systematic review and meta-analysis. Journal of Clinical Medicine. 2023 Mar 2;12(5):1981.https://doi.org/10.3390/jcm12051981
Dahlén AD, Dashi G, Maslov I, Attwood MM, Jonsson J, Trukhan V, Schiöth HB. Trends in antidiabetic drug discovery: FDA approved drugs, new drugs in clinical trials and global sales. Frontiers in Pharmacology. 2022 Jan 19;12:807548.https://doi.org/10.3389/fphar.2021.807548
Wang S, Wang S, Wang Y, Luan J. Glycemic control, weight management, cardiovascular safety, and cost-effectiveness of semaglutide for patients with type 2 diabetes mellitus: a rapid review and meta-analysis of real-world studies. Diabetes Therapy. 2024 Feb;15(2):497-519. https://doi.org/10.1007/s13300-023-01520-3
Chong K, Chang JK, Chuang LM. Recent advances in the treatment of type 2 diabetes mellitus using new drug therapies. The Kaohsiung Journal of Medical Sciences. 2024 Mar;40(3):212-20.https://doi.org/10.1002/kjm2.12800
Yao H, Zhang A, Li D, Wu Y, Wang CZ, Wan JY, Yuan CS. Comparative effectiveness of GLP-1 receptor agonists on glycaemic control, body weight, and lipid profile for type 2 diabetes: systematic review and network meta-analysis. bmj. 2024 Jan 29;384.https://doi.org/10.1136/bmj-2023-076410
Scheen AJ. Careful use to minimize adverse events of oral antidiabetic medications in the elderly. Expert Opinion on Pharmacotherapy. 2021 Nov 2;22(16):2149-65.https://doi.org/10.1080/14656566.2021.1912735
Mohan V, Khunti K, Chan SP, Filho FF, Tran NQ, Ramaiya K, Joshi S, Mithal A, Mbaye MN, Nicodemus Jr NA, Latt TS. Management of type 2 diabetes in developing countries: balancing optimal glycaemic control and outcomes with affordability and accessibility to treatment. Diabetes Therapy. 2020 Jan;11(1):15-35.https://doi.org/10.1007/s13300-019-00733-9
Sahin I, Bakiner O, Demir T, Sari R, Atmaca A. Current position of gliclazide and sulfonylureas in the contemporary treatment paradigm for type 2 diabetes: a scoping review. Diabetes Therapy. 2024 Aug;15(8):1687-716.https://doi.org/10.1007/s13300-024-01612-8
Oda T, Satoh M, Nagasawa K, Sasaki A, Hasegawa Y, Takebe N, Ishigaki Y. The effects of imeglimin on the daily glycemic profile evaluated by intermittently scanned continuous glucose monitoring: retrospective, single-center, observational study. Diabetes Therapy. 2022 Sep;13(9):1635-43.https://doi.org/10.1007/s13300-022-01298-w
Mohajan D, Mohajan HK. Oral hypoglycaemic agents: non-insulin medications for type 2 diabetes patients. Innovation in Science and Technology. 2024 Jan 19;3(1):23-31.https://www.paradigmpress.org/ist/article/view/958
Chandra K, Jain V, Jabin A, Dwivedi S, Joshi S, Ahmad S, Jain SK. Effect of Cichorium intybus seeds supplementation on the markers of glycemic control, oxidative stress, inflammation, and lipid profile in type 2 diabetes mellitus: A randomized, double‐blind placebo study. Phytotherapy Research. 2020 Jul;34(7):1609-18.https://doi.org/10.1002/ptr.6624
Ravikumar L, Kiwalkar RS, Lokesh B, Dabhade D. Dapagliflozin and sitagliptin combination therapy: an overview of clinical utility in type 2 diabetes mellitus with multiple cardiovascular risk factors. Cardiology and Cardiovascular Medicine. 2023 Apr 24;7(2):141-4.https://fortunescholar.org/articles/dapagliflozin-and-sitagliptin-combination-therapy-an-overview-of-clinical-utility-in-type-2-diabetes-mellitus-with-multiple-cardio.html
Dubourg J, Fouqueray P, Quinslot D, Grouin JM, Kaku K. Long‐term safety and efficacy of imeglimin as monotherapy or in combination with existing antidiabetic agents in Japanese patients with type 2 diabetes (TIMES 2): a 52‐week, open‐label, multicentre phase 3 trial. Diabetes, Obesity and Metabolism. 2022 Apr;24(4):609-19.https://doi.org/10.1111/dom.14613
Taylor SI, Yazdi ZS, Beitelshees AL. Pharmacological treatment of hyperglycemia in type 2 diabetes. The Journal of clinical investigation. 2021 Jan 19;131(2).https://www.jci.org/articles/view/142243
Reilhac C, Dubourg J, Thang C, Grouin JM, Fouqueray P, Watada H. Efficacy and safety of imeglimin add‐on to insulin monotherapy in Japanese patients with type 2 diabetes (TIMES 3): a randomized, double‐blind, placebo‐controlled phase 3 trial with a 36‐week open‐label extension period. Diabetes, Obesity and Metabolism. 2022 May;24(5):838-48.https://doi.org/10.1111/dom.14642
Sharma S, Mandal A, Kant R, Jachak S, Jagzape M. Is cinnamon efficacious for glycaemic control in type-2 diabetes mellitus. diabetes. 2020;30:32.https://www.researchgate.net/profile/Suresh-Sharma-34/publication/344811140_Is_Cinnamon_Efficacious_for_Glycaemic_Control_in_Type-2_Diabetes_Mellitus/links/5f919197299bf1b53e3b2319/Is-Cinnamon-Efficacious-for-Glycaemic-Control-in-Type-2-Diabetes-Mellitus.pdf
Chen J, Yin D, Dou K. Intensified glycemic control by HbA1c for patients with coronary heart disease and Type 2 diabetes: a review of findings and conclusions. Cardiovascular Diabetology. 2023 Jun 22;22(1):146.https://doi.org/10.1186/s12933-023-01875-8
Dubourg J, Fouqueray P, Thang C, Grouin JM, Ueki K. Efficacy and safety of imeglimin monotherapy versus placebo in Japanese patients with type 2 diabetes (TIMES 1): a double-blind, randomized, placebo-controlled, parallel-group, multicenter phase 3 trial. Diabetes Care. 2021 Apr 1;44(4):952-9.https://doi.org/10.2337/dc20-0763
Krishnappa M, Patil K, Parmar K, Trivedi P, Mody N, Shah C, Faldu K, Maroo S, Parmar D. Effect of saroglitazar 2 mg and 4 mg on glycemic control, lipid profile and cardiovascular disease risk in patients with type 2 diabetes mellitus: a 56-week, randomized, double blind, phase 3 study (PRESS XII study). Cardiovascular diabetology. 2020 Jun 19;19(1):93. https://doi.org/10.1186/s12933-020-01073-w
Cheng AY, Wong J, Freemantle N, Acharya SH, Ekinci E. The safety and efficacy of second-generation basal insulin analogues in adults with type 2 diabetes at risk of hypoglycemia and use in other special populations: a narrative review. Diabetes therapy. 2020 Nov;11(11):2555-93.https://doi.org/10.1007/s11154-022-09735-8
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Muhammad Nouman Iqbal, Abubakar Ahmad, Akhtar Ali Khan, Muhammad Usman Atta , Dr Iman Masood, Dr IRFAN ALI (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
