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Add-on therapy with dapagliflozin in routine outpatient care of type 2 diabetes patients from Turkey: a retrospective cohort study on HbA1c, body weight, and blood pressure outcomes

  • Original Article
  • Published:
International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Background

The efficacy of dapagliflozin has been less extensively studied in the real-life context, limiting the comparability of observational real-world evidence with results from dapagliflozin clinical trials. This study aimed to evaluate HbA1c, blood pressure (BP), and weight outcomes in dapagliflozin-treated patients with type 2 diabetes (T2D) treated in a real-world setting.

Methods

A total of 1683 T2D patients (mean (SD) age: 54.6 years (9.1), 56.6% were females) initiating dapagliflozin were included in this multicenter retrospective observational cohort study. Data on patient demographics, comorbidities, duration of diabetes, and concomitant antidiabetic treatment were recorded. Change in glycated hemoglobin (HbA1c), body weight, body mass index (BMI), and BP levels with dapagliflozin treatment and dapagliflozin discontinuation rates were evaluated based on baseline, 3rd-month, and 6th-month data.

Results

At the end of 6-month dapagliflozin treatment (discontinued in 4.3% of patients), HbA1c levels were ≤7% in 30.1% of patients, BP was ≤140/90 mmHg in 95.9% of patients, and >5% weight loss was evident in 38.0% of patients. Less than 5-year diabetes duration was associated with significantly higher rate of achieving HbA1c ≤7% (p = 0.032), BP ≤140/90 mmHg (p = 0.001), and BP ≤130/80 mmHg (p < 0.001) targets at the 6th month (p = 0.032) as compared with longer diabetes duration.

Conclusion

In conclusion, this nationwide observational study in T2D patients treated with dapagliflozin in Turkey provided real-life evidence on significant and clinically meaningful reductions in HbA1c, body weight, and BP within 6-month therapy.

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Acknowledgment

This work was supported by Astra-Zeneca Turkey. The authors would like to thank Prof. Sule Oktay, MD, PhD and Cagla Ayhan, MD from KAPPA Consultancy Training Research Ltd (Istanbul, Turkey) for providing editorial support.

The DAPATURK Study Group (Centers are listed in order of enrollment contribution)

1. Derun Taner Ertugrul, M.D., Clinic of Endocrinology, Kecioren Training and Research Hospital, Ankara

2. Ilhan Yetkin, M.D., Clinic of Endocrinology, Gazi University Faculty of Medicine, 3. Ankara

3. Erdal Kan, M.D., Clinic of Endocrinology, Medicana International Hospital, Samsun

4. Cigdem Bahadir Tura, M.D., Clinic of Endocrinology, Tokat State Hospital, Tokat

5. Haci Bayram Tugtekin, M.D., Clinic of Internal Medicine, Umraniye Training and Research Hospital, Istanbul

6. Hayati Ayakta, M.D., Clinic of Endocrinology, Private Grandmedical Hospital, Manisa

7. Mehmet Çelebioglu, M.D., Clinic of Internal Medicine, Private Anadolu Hospital, Eskisehir

8. Eren Gurkan, M.D., Clinic of Endocrinology, Mustafa Kemal University Faculty of Medicine, Hatay

9. Kerem Sezer, M.D., Clinic of Endocrinology, Mersin University Faculty of Medicine, Mersin

10. Ramazan Gen, M.D., Clinic of Endocrinology, Mersin University Faculty of Medicine, Mersin

11. Suleyman Ozcaylak, M.D., Clinic of Internal Medicine, Diyarbakir Health Sciences University Gazi Yasargil Training and Research Hospital, Diyarbakir

12. Yildiz Okuturlar, M.D., Clinic of Internal Medicine, Health Sciences University Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul

13. Mehmet Coskun, M.D., Clinic of Internal Medicine, Diyarbakir Health Sciences University Gazi Yasargil Training and Research Hospital, Diyarbakir

14. Nilgun Govec Giynas, M.D., Clinic of Internal Medicine, Ankara Training and Research Hospital, Ankara

15. Harun Aysal, M.D., Clinic of Internal Medicine, Antalya Atatürk State Hospital, Antalya

16. Ayca Serap Erdem, M.D., Clinic of Internal Medicine, Uskudar State Hospital, Istanbul

17. Mustafa Aydemir, M.D., Clinic of Endocrinology, Afyon State Hospital, Afyon

18. Okan Bakiner, M.D., Clinic of Endocrinology, Baskent University Faculty of Medicine, Adana

19. Emre Cicekli, M.D., Clinic of Internal Medicine, Medicana International Hospital, Sivas

20. Deniz Gezer, M.D., Clinic of Internal Medicine, Mersin City Training and Research Hospital, Mersin

21. Ramazan Kaya, M.D., Clinic of Internal Medicine, Tarsus State Hospital, Mersin

22. Levent Kebapcilar, M.D., Clinic of Internal Medicine, Selcuk University Faculty of Medicine, Konya

23. Umit Cinkir, M.D., Clinic of Endocrinology, Medical Park Gaziantep Hospital, Gaziantep

24. Memmune Sena Ulu, M.D., Clinic of Nephrology, Kocatepe University Faculty of Medicine, Afyon

25. Canan Ersoy, M.D., Clinic of Endocrinology, Uludag University Faculty of Medicine, Bursa

26. Mustafa Timur Kagan, M.D., Clinic of Internal Medicine, Elazig Training and Research Hospital, Elazig

27. Berna Dalmis Ekiz, M.D., Clinic of Internal Medicine, Izan Private Health Hospital, Mugla

28. Faruk Kilinc, M.D., Clinic of Endocrinology, Firat University Faculty of Medicine, Elazig

29. Kevser Onbasi, M.D., Clinic of Endocrinology, Dumlupinar University Faculty of Medicine, Kutahya

30. Mahir Cengiz, M.D., Clinic of Internal Medicine, Istanbul University Cerrahpasa Faculty of Medicine, İstanbul

31 Mehmet Celik, M.D., Clinic of Internal Medicine, Antalya Training and Research Hospital, Antalya

32. Metin Guclu, M.D., Clinic of Endocrinology, Health Sciences University Bursa Yüksek Ihtisas Education and Research Hospital, Bursa

33. Metin Sarıkaya, M.D., Clinic of Nephrology, Health Sciences University Antalya Training and Research Hospital, Antalya

34. Ozcan Ozbag, M.D., Clinic of Internal Medicine, Dr.Ersin Arslan Training and Research Hospital, Gaziantep

35. Ramazan Sari, M.D., Clinic of Endocrinology, Akdeniz University Faculty of Medicine, Antalya

36. Rifki Ucler, M.D., Clinic of Endocrinology, Van 100. Yil University Faculty of Medicine, Van

37. Selcuk Sezikli, M.D., Clinic of Internal Medicine, Merzifon State Hospital, Amasya,

38. Mustafa Araz, M.D., Clinic of Endocrinology, Gaziantep University Faculty of Medicine, Gaziantep

39. Erdal Gundogan, M.D., Clinic of Internal Medicine, Bagcilar Training and Research Hospital, Istanbul

40. Erhan Bozkurt, M.D., Clinic of Internal Medicine, Afyonkarahisar Emirdag State Hospital, Afyon

41. Murat Akbas, M.D., Clinic of Internal Medicine, Istanbul Eyupsultan State Hospital, Istanbul

42. Rifat Bozkus, M.D., Clinic of Internal Medicine, Ulus State Hospital, Ankara

43. Baris Akinci, M.D., Clinic of Endocrinology, 9 Eylül University Faculty of Medicine, Izmir

44. Ersen Karakilic, M.D., Clinic of Endocrinology, Canakkale State Hospital, Canakkale

45. Murat Medeni, M.D., Clinic of Internal Medicine, Bornova Turkan Ozilhan State Hospital, Izmir

46. Ozgur Keskek, M.D., Clinic of Endocrinology, Adana City Hospital, Adana

47. Enver Sukru Goncuoglu, M.D., Clinic of Endocrinology, Dr. Nazif Bagriacik Kadikoy State Hospital, Istanbul

48. Sayid Shafi Zuhur, M.D., Clinic of Internal Medicine, Namık Kemal University Faculty of Medicine, Tekirdag

49. Ahmet Ziya Sahin, M.D., Clinic of Internal Medicine, Cukurova Dr.Askim Tufekci State Hospital, Adana

50. Kursat Dal, M.D., Clinic of Endocrinology, Kecioren Training and Research Hospital, Ankara

51. Mehmet Ali Eren, M.D., Clinic of Endocrinology, Harran University Faculty of Medicine, Sanlıurfa

52. Tugba Arkan, M.D., Clinic of Endocrinology, Kocaeli Health Sciences University Derince Training and Research Hospital, Kocaeli

53. Bengur Taskiran, M.D., Clinic of Internal Medicine, Eskisehir Yunus Emre State Hospital, Eskisehir

54. Gokturk Kilinc, M.D., Clinic of Internal Medicine, Fethiye State Hospital, Mugla

55. Emre Bozkirli, M.D., Clinic of Endocrinology, Baskent University Faculty of Medicine, Adana

56. Sabriye Ozkaya Kafesciler, M.D., Clinic of Endocrinology, Manisa State Hospital, Manisa

57. Nuh Baklaci, M.D., Clinic of Endocrinology, Private Antakya Akademi Hospital, Hatay

58. Esra Cil Sen, M.D., Clinic of Endocrinology, SiSli Hamidiye Etfal Training and Research Hospital, Istanbul

59. Sahin Doganay, M.D., Clinic of Endocrinology, Yildirim Beyazit University Yenimahalle Training and Research Hospital, Ankara

60. Caglar Koseoglu, M.D., Clinic of Internal Medicine, Golbasi State Hospital, Ankara

61. Tamer Tetiker, M.D., Clinic of Endocrinology, Cukurova University Faculty of Medicine, Adana

62. Taner Bayraktaroglu, M.D., Clinic of Endocrinology, Zonguldak Bulent Ecevit University Faculty of Medicine, Zonguldak

63. Aytekin Oguz, M.D., Clinic of Internal Medicine, Istanbul Medeniyet University Faculty of Medicine, Istanbul

64. Esra Ataoglu, M.D., Clinic of Internal Medicine, Istanbul Haseki Training and Research Hospital, Istanbul

65. Muhammed Mustafa Demirpence, M.D., Clinic of Endocrinology, Izmir Health Sciences University Tepecik Training and Research Hospital, Izmir

66. Semra Tursun, M.D., Clinic of Internal Medicine, Private Tekden Hospitals, Denizli

67. Inan Anaforoglu, M.D., Clinic of Endocrinology, Medical Park Trabzon Hospital, Trabzon

68. Omur Tabak, M.D., Clinic of Internal Medicine, Istanbul Health Sciences University Kanuni Sultan Suleyman Training and Research Hospital, Istanbul

69. Rifat Emral, M.D., Clinic of Endocrinology, Ankara University Faculty of Medicine, Ankara

70. Kubilay Karsidag, M.D., Clinic of Endocrinology, Istanbul University Istanbul Faculty of Medicine, Istanbul

71. Oguzhan Sitki Dizdar, M.D., Clinic of Internal Medicine, Kayseri Training and Research Hospital, Kayseri

72. Alparslan Kemal Tuzcu, M.D., Clinic of Endocrinology, Dicle University Faculty of Medicine, Diyarbakir

73. Mustafa Caliskan, M.D., Clinic of Internal Medicine, Duzce Atatürk State Hospital, Duzce

74. Pinar Sirmatel, M.D., Clinic of Internal Medicine, Edirne Sultan I. Murat State Hospital, Edirne

75. Yasin Kocaoz, M.D., Clinic of Internal Medicine, Izmir Menemen State Hospital, Izmir

76. Hakan Dogan, M.D., Clinic of Internal Medicine, Health Sciences University Izmir Bozyaka Training and Research Hospital, Izmir

77. Semin Melahat Fenkci, M.D., Clinic of Endocrinology, Pamukkale University Faculty of Medicine, Denizli

78. Ibrahim Sahin, M.D., Clinic of Endocrinology, Inonu University Faculty of Medicine, Malatya

79. Zuleyha Karaca, M.D., Clinic of Endocrinology, Erciyes University Faculty of Medicine, Kayseri

Funding

Astra-Zeneca Turkey

Author information

Authors and Affiliations

  1. Clinic of Endocrinology, Kecioren Training and Research Hospital, Pinarbasi, 06000 Kecioren, Ankara, Turkey

    Derun Taner Ertugrul

  2. Clinic of Endocrinology, Samsun Medicana Hospital, Samsun, Turkey

    Erdal Kan

  3. Clinic of Endocrinology, Tokat State Hospital, Tokat, Turkey

    Cigdem Bahadir Tura

  4. Clinic of Internal Medicine, Umraniye Training and Research Hospital, Istanbul, Turkey

    Haci Bayram Tugtekin

  5. Clinic of Endocrinology, Manisa Grand Medical Hospital, Manisa, Turkey

    Hayati Ayakta

  6. Clinic of Internal Medicine, Eskisehir Anadolu Hospital, Eskişehir, Turkey

    Mehmet Celebioglu

  7. AstraZeneca Pharmaceuticals, Istanbul, Turkey

    Ceren Yılmaz & Onur Utebay

  8. Department of Endocrinology and Metabolism, Gazi University Faculty of Medicine, Ankara, Turkey

    Ilhan Yetkin

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  1. Derun Taner Ertugrul
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  2. Erdal Kan
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  3. Cigdem Bahadir Tura
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  4. Haci Bayram Tugtekin
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  5. Hayati Ayakta
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  7. Ceren Yılmaz
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  9. Ilhan Yetkin
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Consortia

The DAPATURK Study Group

  • Eren Gurkan
  • , Kerem Sezer
  • , Ramazan Gen
  • , Suleyman Ozcaylak
  • , Yildiz Okuturlar
  • , Mehmet Coskun
  • , Nilgun Govec Giynas
  • , Harun Aysal
  • , Ayca Serap Erdem
  • , Mustafa Aydemir
  • , Okan Bakiner
  • , Emre Cicekli
  • , Deniz Gezer
  • , Ramazan Kaya
  • , Levent Kebapcilar
  • , Umit Cinkir
  • , Memmune Sena Ulu
  • , Canan Ersoy
  • , Mustafa Timur Kagan
  • , Berna Dalmis Ekiz
  • , Faruk Kilinc
  • , Kevser Onbasi
  • , Mahir Cengiz
  • , Mehmet Celik
  • , Metin Guclu
  • , Metin Sarıkaya
  • , Ozcan Ozbag
  • , Ramazan Sari
  • , Rifki Ucler
  • , Selcuk Sezikli
  • , Mustafa Araz
  • , Erdal Gundogan
  • , Erhan Bozkurt
  • , Murat Akbas
  • , Rifat Bozkus
  • , Baris Akinci
  • , Ersen Karakilic
  • , Murat Medeni
  • , Ozgur Keskek
  • , Enver Sukru Goncuoglu
  • , Sayid Shafi Zuhur
  • , Ahmet Ziya Sahin
  • , Kursat Dal
  • , Mehmet Ali Eren
  • , Tugba Arkan
  • , Bengur Taskiran
  • , Gokturk Kilinc
  • , Emre Bozkirli
  • , Sabriye Ozkaya Kafesciler
  • , Nuh Kafesciler
  • , Esra Cil Sen
  • , Sahin Doganay
  • , Caglar Koseoglu
  • , Tamer Tetiker
  • , Taner Bayraktaroglu
  • , Aytekin Oguz
  • , Esra Ataoglu
  • , Muhammed Mustafa Demirpence
  • , Semra Tursun
  • , Inan Anaforoglu
  • , Omur Tabak
  • , Rifat Emral
  • , Kubilay Karsidag
  • , Oguzhan Sitki Dizdar
  • , Alparslan Kemal Tuzcu
  • , Mustafa Caliskan
  • , Pinar Sirmatel
  • , Yasin Kocaoz
  • , Hakan Dogan
  • , Semin Melahat Fenkci
  • , Ibrahim Sahin
  •  & Zuleyha Karaca

Corresponding author

Correspondence to Derun Taner Ertugrul.

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Ethics approval

The study was approved by the institutional ethics committee and conducted in accordance with the Declaration of Helsinki, the International Conference on Harmonization of Good Clinical Practice, and the local regulations for clinical research.

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This is a retrospective observational cohort study.

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Permission was obtained from our institutional ethics committee for the use of patient data for publication purposes.

Conflict of interest

Ceren Yilmaz, M.D and Onur Utebay, M.D are Astra-Zeneca employees. Other authors declare that they have no conflict of interest.

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Ertugrul, D.T., Kan, E., Tura, C.B. et al. Add-on therapy with dapagliflozin in routine outpatient care of type 2 diabetes patients from Turkey: a retrospective cohort study on HbA1c, body weight, and blood pressure outcomes. Int J Diabetes Dev Ctries 42, 147–160 (2022). https://doi.org/10.1007/s13410-021-00954-4

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