The Positive Effect of the Combination of GLP-1 Analogues and SGLT2 Inhibitors on Obese Patients with Noninsulin-Treated DM2

Introduction: GLP-1 analogues and SGLT2 inhibitors have complementary mechanisms of action. The aim of the study is to evaluate the results and tolerance of the combination of these medicines. Purpose: To investigate the effect of the combination of GLP-1 analogues and SGLT2 inhibitors on obese patients with non-insulin-treated DM2. Method: The study included 150 patients, out of which 110 (73.3%) were women with a mean age of 58 ± 5 years and 40 (26.6%) were men with a mean age of 62 ± 6 years, The mean BMI was 36± 4 and all patients received oral medication for the treatment of DM2 (metformin ± DPP-4 ± sulfonylureas ± glitazone). The study duration was one year and HbA1c, fasting glucose, body weight, and body mass index (BMI) were measured at 3, 6, 9 and 12 months. All patients changed their medication to metformin + GLP-1 + SGLT2. Results: A decrease in HbA1c levels were observed at 3 months (mean HbA1c 10 ± 1.8), at 6 months (mean HbA1c 9 ± 1.3), at 9 months (mean HbA1c 8.7 ± 1) and at 12 months (mean HbA1c 7 ± 0.8) (p = 0.030). Fasting glucose also showed a gradual reduction in the follow-up tests, namely 185 ± 29mg / dl, 168 ± 22mg / dl, 156 ± 20mg / dl and 145 ± 18mg / dl at 3, 6, 9 and 12 months respectively (p = 0.0045). Same results were also observed when body weight was measured at 3,6,9 and 12 months (125 ± 18 kg, 1± 14 kg, 100 ± 8 kg and 98 ± 8 kg respectively) (p = 0,042). Changes in BMI were also occured with a mean BMI of 42 ± 7.2 at 3 months, 40 ± 6.8 at 6 months, 38 ± 6.4 at 9 months and 35 ± 5 at 12 months of follow-up period (p = 0.043). Conclusion: The combination of metformin + GLP-1 + SGLT2 has many benefits in the metabolic profile of obese patients with DM2 and could be considered as a choice treatment.