А.V. STEFANENKO, A.E. BAGRIY, E.S. MIKHAILICHENKO, E.R. STEFANENKO, YA.A. SOVPEL 

1. Gorky Donetsk State Medical University, Donetsk

 Contact details:

Mikhailichenko E.S. — PhD (Medicine), Associate Professor of the Department of Internal Diseases № 2

Address: 16 prospekt Ilyicha, Donetsk, Russian Federation, 283003, tel.: +7-949-470-68-08; e-mail: klassiki@inbox.ru

The purpose to study the organoprotective efficacy and safety of dapagliflozin in patients with type 2 diabetes mellitus.

Material and methods. The study included 62 patients with type 2 diabetes mellitus (average age 63.1 (9.3) years). All patients underwent a standard examination to determine the levels of glycated hemoglobin (HbA1C), lipids, creatinine, glomerular filtration rate (GFR), uric acid and cystatin C in the blood, and albumin-creatinine ratio (ACR) of urine. Echocardiographic examinations, ultrasound examinations of the brachiocephalic arteries, and a test with reactive hyperemia were performed. All patients were recommended adequate hypoglycemic, hypotensive and organoprotective therapy. Using the envelope method, patients were randomized into 2 groups: group A consisted of 32 people who were prescribed dapagliflozin at a dose of 10 mg/day as a component of hypoglycemic therapy; and group B, which included 30 people who received other classes of hypoglycemic drugs (without gliflozines). The duration of observation was 6 months.

Results. In both groups, there was a distinct comparable decrease in HbA1C values, as well as a decrease in blood pressure levels, more significant in group A. The treatment had a significant beneficial effect on the parameters of cardiovascular remodeling, more expressed in the dapagliflozin group. In group A, after 6 months, the degree of increase in GFR was 10.2 (4.1) %, in group B, no such effect was found. In group A, ACR values decreased by 49.7 (24.2) % in 6 months. In group B, a similar effect also occurred, but was less significant. A more significant renoprotective effect of dapagliflozin was recorded in individuals with stage III CKD, baseline ACR levels > 300 mg/g, and cystatin C concentrations > 1.4 mcg/ml.

Conclusions. The high hypoglycemic and organoprotective efficacy of dapagliflozin, demonstrated in this study, motivates its wider use in clinical practice.

Key words: diabetes mellitus, cardioprotection, nephroprotection, sodium glucose cotransporter 2 inhibitor, dapagliflozin.

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