Aim:

To compare obesity progression and the type2 diabetes mellitus (T2DM) metabolic control between 2017 and 2019, according to sodium-glucose cotransporter type 2 inhibitors (SGLT2i) or not therapy, in the T2D population of the Central Administrative Portuguese National Health Service Authority, the ARS do Centro.

Methods:

Observational retrospective cohort study in 2021 of data by the informatic services of ARS do Centro, after ethics consent: gender, age, year of ICPC2 T90 classification, abdominal perimeter (AP), body mass index (BMI), last glycated haemoglobin (HbA1c) in 2017 and 2019 and drugs registered in the e.registration official program, the S-Clínico Diabetes.

Results:

Out of the 127,062 T2DM patients of the ARS do Centro n=16.012 (12.6%) were on SGLT2i in 2017. The mean age was 73.5±10.1 years, the time since ICPC classification was 8.7±4.2 years and 48.8% were males. HbA1C, BMI and AP values between 2017 and 2019 were independent for age and time since diagnosis, |rS| <0.400. Median HbA1c values between the two moments, in the total sample and the subgroups medicated with SGLT2i and per gender were significantly different (p<0.001) values increasing. No difference was observed in the subgroups not SGLT2i treated, either globally (p=0.983) or per gender (M: p=0.932; F: p=0.932). BMI in SGLT2i treated T2DM showed significant negative variation (p<0.001) also observed in nonSGLT2i treated ones (p=0.004). AP values significantly increased in nonSGLT2i T2DM patients (p=0.001) and significantly decreased in the SGLT2i treated ones (p<0.001).

Discussion:

The efficacy of SGLT2i in clinical assays and its effectiveness in real-world patients must be ascertained. Obesity decrease in BMI or AP can contribute to future T2DM analytics control.

Conclusion:

SGLT2i significantly decreased BMI and prevented AP increase, compared to non-SGLT2 T2DM patients. HbA1c control, in a 2-year gap, showed no decrease in growth.

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