Horm Metab Res 2022; 54(11): 747-753
DOI: 10.1055/a-1932-0194
Original Article: Endocrine Care

Reduction of Severe Hypoglycemic Events Among Outpatients with Type 2 Diabetes Following Sodium-Glucose Cotransporter 2 Inhibitor Marketing in Japan

Koh Yamashita
1   Diabetes Center, Aizawa Hospital, Matsumoto, Japan
,
Shouichi Yoshiike
2   Critical Care Center, Aizawa Hospital, Matsumoto, Japan
,
Taku Yamashita
3   School of Pharmacy, Mukogawa Women’s University, Nishinomiya, Japan
,
Jun-ichirou Mori
4   Center for Medical Education, Faculty of Medicine, Shinshu University, Matsumoto, Japan
,
Toru Aizawa
1   Diabetes Center, Aizawa Hospital, Matsumoto, Japan
› Author Affiliations

Abstract

Recently, oral hypoglycemic agents with newer glucose lowering mechanisms have been on release. This is mostly to meet the diabetic patient’s need to avoid hypoglycemia, which is profoundly important for better long-term outcome of the treatment. In this study, we quantified the annual number of patients with type 2 diabetes who experienced hypoglycemia needing the third-party assistance who had random sample plasma glucose<59.4 mg/dl (3.3 mmol/l) on the one hand and analyzed the prescription trend of hypoglycemic agents all over Japan on the other. Analysis of the annual number of hypoglycemic patients visited ER was performed at Aizawa Hospital, a medical center located in the midst of a city. The study duration was over 10 years from 2008 to 2019. We found a clear-cut decreasing trend of hypoglycemia over the 10 years, ca. 61/year to 39/year. Immediately after the release of sodium-glucose co-transporter-2 inhibitors, since 2013 to 2017, the decrease was rather sharp as 81/year to 31/year, and the change of the national number of its prescription inversely correlated with the change of the number of the patients with hypoglycemia. This was not the case immediately after the introduction of dipeptidyl peptidase-4 inhibitors in the Japanese market since 2008 to 2012. There was no significant correlation between its prescription and the number of patients with hypoglycemia. The data strongly suggested that there was a causal relationship exclusively between the introduction of sodium-glucose cotransporter-2 inhibitor, and the reduction of hypoglycemic events among patients with type 2 diabetes.



Publication History

Received: 12 April 2022

Accepted after revision: 26 August 2022

Accepted Manuscript online:
26 August 2022

Article published online:
10 November 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Tan YZ, Cheen McVHH, Goh S-Y. et al. Trends in medication utilization, glycemic control and outcomes among type 2 diabetes patients in a tertiary referral center in Singapore from 2007 to 2017. J Diabetes 2019; 11: 573-581
  • 2 Dennis JM, Henley WE, McGovern AP. et al. Time trends in prescribing of type 2 diabetes drugs, glycaemic response and risk factors: a retrospective analysis of primary care data, 2010-2017. Diabetes Obes Metab 2019; 21: 1576-1584
  • 3 Zoungas S, Patel A, Chalmers J. et al. Severe hypoglycemia and risks of vascular events and death. N Engl J Med 2010; 363: 1410-1418
  • 4 Alkabbani W, Gamble J-M. Profile of ipragliflozin, an oral SGLT-2 inhibitor for the treatment of Type 2 diabetes: the evidence to date. Drug Des Devel Ther 2021; 15: 3057-3069
  • 5 Cryer PE, Fisher JN, Shamoon H. Hypoglycemia. Diabetes Care 1994; 17: 734-755
  • 6 Matsuo S, Imai E, Horio M. et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis 2009; 53: 982-992
  • 7 Zinman B, Wanner C, Lachin JM. et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med 2015; 373: 2117-2128
  • 8 Scheen AJ. Beneficial effects of SGLT2 inhibitors on fatty liver on type 2 diabetes: a common comorbidity associated with severe complications. Diabetes Metab 2019; 45: 213-223
  • 9 Heerspink HJL, Stefánsson BV, Correa-Rotter R. et al. Dapagliflozin in patients with chronic kidney disease. N Engl J Med 2020; 383: 1436-1446
  • 10 Chia CW, Egan JM. Incretin-based therapies in type 2 diabetes mellitus. J Clin Endocrinol Metab 2008; 93: 3703-3716
  • 11 Abdul-Ghani MA, DeFronzo RA. Lowering plasma glucose concentration by inhibiting renal sodium-glucose cotransport. J Intern Med 2014; 276: 352-363
  • 12 Arechavaleta R, Seck T, Chen Y. et al. Efficacy and safety of treatment with sitagliptin or glimepiride in patients with type 2 diabetes inadequately controlled on metformin monotherapy: a randomized, double-blind, non-inferiority trial. Diabetes Obes Metab 2011; 13: 160-168
  • 13 Kim J, Park S, Kim H. et al. National trends in metformin-based combination therapy of oral hypoglycaemic agents for type 2 diabetes mellitus. Eur J Clin Pharmacol 2019; 12: 1723-1730
  • 14 Moura AM, Martins SO, Raposo JF. Consumption of antidiabetic medicines in Portugal: results of a temporal data analysis of a thirteen-year study (2005-2017). BMC Endocr Disord 2021; 21: 30