J Diabetes Investig. 2022 May 7. doi: 10.1111/jdi.13825. Online ahead of print.
ABSTRACT
AIMS/INTRODUCTION: We previously reported that sodium-glucose cotransporter 2 inhibitor (SGLT2i) treatment was associated with an improvement of the albumin-creatinine ratio (ACR) in Japanese patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). The present study clarified how concomitant insulin treatment (IT) with SGLT2i therapy influences the renal composite outcome (RCO).
MATERIALS AND METHODS: We retrospectively evaluated 624 Japanese patients with T2DM and CKD who underwent SGLT2i treatment. The renal composite outcome was set as progression of the stage of albuminuria or a ≥15% decrease in the estimated glomerular filtration rate (eGFR) per year. We developed a cohort model of patients managed with and without IT (Ins [+], Ins [-]) using propensity score matching methods. Furthermore, all patients in our study population were stratified into quintiles according to their propensity score.
RESULTS: The incidence of the RCO was in Ins (+) patients significantly higher than that in Ins (-) (p=0.033). The estimated hazard ratio for the RCO was 1.55 (p=0.035) in Ins (+) patients. The change in the eGFR and ACR in the groups did not statistically significant. The analysis, which was based on the quintiles revealed a statistically significant difference between the Ins (+) and Ins (-) groups (p=0.01); the odds ratio for the RCO in patients managed with IT was 2.20 (p=0.01).
CONCLUSIONS: Concomitant administration of IT with SGLT2is influenced the RCO in Japanese patients with T2DM and CKD. We might need to consider the influence of concomitant agents on the renoprotective effects of SGLT2i therapy.
PMID:35524473 | DOI:10.1111/jdi.13825
