Aims: We aim to evaluate impact of Metformin vs Dapagliflozin vs combination (Dapagliflozin/Metformin) on surrogate measures of cardiovascular risk - endothelial function, artery stiffness and carotid artery intima-media thickness (CIMT) in a 12 week, randomized controlled study.
Methods: We screened 223 participants using oral glucose tolerance test. Participants with Type 2 DM were included. Primary outcome variables were arterial stiffness (cf-PWV-Sphygmocor), endothelial function (RHI-EndoPAT), and CIMT. ANCOVA model was fitted for change from baseline, to examine drug effect on the variables adjusting for baseline and change from baseline in HbA1c. Pairwise comparisons between the treatment arms were performed.
Results: We recruited 60 participants (Age: 50.2 (8.1) years, Male 30(50%)) to Metformin (n=21), Dapagliflozin (n=18) or Metformin & Dapagliflozin (n=21). We found a statistically significant difference in CIMT between the Metformin arm and the Dapagliflozin arm (difference: 0.06; 95% CI: 0.01 - 0.11; p-value=0.03 ). The difference in cf-PWV and ln-RHI did not reach statistical significance (p>0.05) (Figure 1).
Conclusion: Initial treatment with Dapagliflozin gives a better response than Metformin for CIMT. Larger-scale longitudinal studies will clarify the potential of SGLT-2 inhibitors as initial diabetes pharmacotherapy.
R. Dalan: None. Y. Chee: None. X. Zhang: None.
National Medical Research Council (MOH-000014)
