SUN-155 Clinical Experience of SGLT2 Inhibitors in a Hispanic Population: Should We Consider Its Use as Add-On Treatment?

Introduction: 1 in 11 adults have DM globally,(1) and Hispanics have higher complication rates.(2) A study determined that ~$16,750/year are spent by patients in medical related costs, of which ~$9,600 are related to diabetes.(3) Half of Type 2 Diabetes Mellitus (T2DM) patients aren't achieving HbA1C targets,(4) uncovering the need for treatment intensification. The primary purpose of this study was to assess the mean reduction in HbA1C between T2DM patients treated with SGLT2 inhibitors (SGLT2I) as adjunct therapy versus patients using other treatments not including SGLT2I. METHOD: T2DM patients with HbA1C > 7 (n=130) were selected for this retrospective cohort study; 69 SGLT2I users and 61 SGLT2I non-users. Medical records were reviewed and demographics, treatment received, HbA1C and side effects were evaluated during a 6-month follow-up period. RESULTS: The average baseline HbA1C for patients using vs not using SGLT2I as add-on was similar with a mean difference of 0.225 [CI -0.41-0.86], p<0.486. The mean difference in HbA1C at 6 months follow-up between both groups was -1.06 [95%CI: -1.70, -0.42], p<0.001. Adjusting for confounders resulted in a regression coefficient of -1.07 [95%CI: -1.85, -0.29], p<0.008, the null hypothesis was rejected and it was concluded that the use of SGLT2I is responsible for the increased HbA1C in the treatment group. CONCLUSION: Puerto Rico is under an economic crisis that affects patients treatment warranted by the availability of some medications due to affordability as supported by Roglic et al.(5) The present study depicts a higher A1C reduction in patients using SGLT2 inhibitors as adjunctive treatment. But should we consider it as add-on treatment of T2DM? We may say that if patients are able to bear the expense of SGLT2I and/or are close to target it may be used as adjunctive treatment since the mean difference in A1C between both groups was -1.07 at 6 months. Limitations were the short follow up duration and a small population using SGLT2I due to high medication costs. REFERENCES: 1. Zheng Y, et al. (2017) Global Aetiology and Epidemiology of T2DM and its Complications. Nat Rev Endocrinol, 14(2), 88-98. 2. Hazel L, et al. (2015) Racial/Ethnic and Gender Differences in Severity of Diabetes-Related Complications, Health Care Resource Use, and Costs in a Medicare Population. Popul Health Manag, 18(2), 115-22. 3. Campos C. (2007) Addressing Cultural Barriers to the Successful Use of Insulin in Hispanics With T2 Diabetes. South Med J, 100(8), 812- 20. 4. Ali M, et al. (2013) Achievement of Goals in U.S. Diabetes Care, 1999-2010. N Engl J Med, 368(17), 1613-24. 5. Roglic G, et al. (2018) Medicines for Treatment Intensification in T2 Diabetes and Type of Insulin in T1 and T2 Diabetes in Low-Resourse Settings: Synopsis of the WHO on Second and Third Line Medicines and Type of Insulin for the Control of Blood Glucose Levels in Nonpregnant Adults With DM. Ann Intern Med, 169(6), 394-97.