Comparative Effects of Dapagliflozin versus Linagliptin as Add-on to Metformin on Glycemic and Renal Outcomes: A 24-Week Non-Randomized Prospective Observational Cohort Study in Indian Patients with Type 2 Diabetes Mellitus and Stage 2-3a chronic kidney disease
Abstract
Abstract Background: Diabetic nephropathy remains one of the leading causes of end-stage renal disease among individuals diagnosed with type 2 diabetes mellitus (T2DM). Achieving optimal glycaemic control plays a vital role in slowing the progression of diabetic kidney disease. However, real-world evidence directly comparing the impact of SGLT2 inhibitors versus DPP-4 inhibitors on kidney outcomes in Indian patients with diabetes is currently limited. This study evaluated the efficacy and safety profile of dapagliflozin in comparison with linagliptin, each added to background metformin therapy, with respect to glycemic control and renal parameters in patients presenting with uncontrolled T2DM and coexisting diabetic kidney disease. Methods: This 24-week, single-centre, non-randomized open-label prospective cohort study included 94 adult patients with uncontrolled T2DM (HbA1c 8.0–10%) and CKD stage 2-3a (eGFR 45–89 mL/min/1.73 m²). Based on treating physician’s clinical judgement, patients received either linagliptin 5 mg daily (n=47) or dapagliflozin 10 mg daily (n=47) in addition to ongoing metformin therapy. The primary outcome was the change in HbA1c at 24 weeks. Secondary outcomes included mean changes in eGFR, urinary albumin-to-creatinine ratio (uACR), and the proportion of patients achieving HbA1c Results: A total of 88 patients completed the study (6 lost to follow-up). Both treatment arms demonstrated significant reductions in HbA1c (linagliptin: –0.79%;…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 94 participants or records.
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