A team of Melbourne researchers, led by Monash University in collaboration with the Baker Heart and Diabetes Institute, have used national data to determine that drugs used to treat diabetes may be associated with a reduction in hospitalisations for infections (including sepsis and pneumonia), anemias and obstructive airway diseases, among Australians living with type 2 diabetes.
Using National Diabetes Services Scheme (NDSS) data, the researchers compared hospitalisation rates between people initiating a class of drugs called 'sodium-glucose co-transporter 2 inhibitors' (SGLT2is) versus another class of drugs called 'dipeptidyl peptidase-4 inhibitors' (DPP4is), which are both used to control high blood sugar levels.
The large-scale cohort study, published in the journal Clinical Pharmacology and Therapeutics, led not only to the discovery of potential new benefits of SGLT2i, but may also inform tailored prescribing of glucose-lowering drugs, and even lead to new uses for SGLT2is.
Lead author, pharmacist and Monash Centre for Medicine Use and Safety PhD candidate, George Tan, said people living with diabetes are at high risk of developing additional health complications and therefore there is an increasing focus on the prescribing of drugs that not only improve glycemic control, but also reduce the risks of traditional and emerging complications.
"SGLT2is have been used globally to lower glucose levels in type 2 diabetes since approval by the US Food and Drug Administration (FDA) in 2013. Since then, randomised clinical trials have led to significant and exciting new discoveries in correlation with SGLT2is, resulting in the FDA approving the class of drugs for treatment of heart failure in 2020 and chronic kidney disease in 2021," said Mr Tan.
Co-senior author, Professor Dianna Magliano OAM from the Baker Heart and Diabetes Institute said, "Our study aimed to use real-world data to identify completely new associations between SGLT2i use and health outcomes. By looking at NDSS data including Australians of all ages with type 2 diabetes, we have managed to pinpoint new ways in which SGLT2i may reduce associated health risks in people with type 2 diabetes, most notably in the reduction of life-threatening infections, obstructive airway diseases and anemias."
The study cohort included people of all ages registered on the NDSS with type 2 diabetes who resided in Victoria, New South Wales, Queensland, or ACT at any time between December 1, 2013, and June 30, 2019, accounting for ~ 80 per cent of all people serviced by the NDSS.
Dr. Jenni Ilomäki, a co-senior author and a PhD supervisor of Mr Tan said, "Our hope is that these exciting new findings could lead to further studies to confirm these associations, with the aim to better understand the full range of benefits of SGLT2i when prescribing glucose-lowering drugs, and to also potentially repurpose SGLT2i for new indications."
This study was conducted by researchers from Monash University's Centre for Medicine Use and Safety which sits within the Monash Institute of Pharmaceutical Sciences, located in Parkville. Other members of the team include CMUS researchers Dr Jed Morton and Dr Stephen Wood, along with Professor Jonathan Shaw from the Baker Heart and Diabetes Institute.
Click here to read the full study, entitled SGLT-2 Inhibitor Use and Cause-Specific Hospitalisation Rates: An Outcome-Wide Study to Identify Novel Associations of SGLT-2 Inhibitors.
DOI: https://doi.org/10.1002/cpt.3194
