901-P: Effects of Dapagliflozin, Metformin, or Exercise on Glycaemic Variability and Mean Glucose Levels in Prediabetes: The PRE-D Trial

Introduction: We assessed the efficacy of three glucose-lowering interventions in persons with HbA_1c-defined prediabetes.

Methods: 120 participants were randomised 1:1:1:1 to 13 weeks of 1) dapagliflozin (DAP, 10 m/day); 2) metformin (MET, 1700 mg/day); 3) exercise (EXE, 5 x 30 min/week); or 4) control (CON, no treatment). Continuous glucose monitor (CGM) was used for 6 days before, during (6 weeks) and after (13 weeks) the intervention. Treatments were stopped the day before the last visit (two days before in EXE). Primary outcome was 13-week change in mean amplitude of glycaemic excursions (MAGE). Intention-to-treat analysis was conducted.

Results: At baseline, median (Q1;Q3) HbA_1c was 5.9 (5.7;6.1)%; BMI 30.8 (28.6;34.3) kg/m²; age 62 (54;68) years; 44% were men. No within- or between-group changes were observed for MAGE. Mean CGM glucose (MG) was slightly reduced in MET and DAP at 6 weeks (Table 1). The 6-week change in MG in DAP was different from that in CON (mean diff. (95% CI): -0.3 mM (-0.5;0.0), P=0.031). At 13 weeks, MG had increased in MET and CON, and the change in MET was different from those in EXE (0.2 mM (0.0;0.5), P=0.041) and DAP (0.2 mM (0.0;0.5), P=0.039).

Conclusion: 13 weeks of treatment with MET, DAP or EXE did not change MAGE. Treatment with DAP or MET for 6 weeks slightly reduced MG; these improvements disappeared immediately after treatments were stopped at 13 weeks.

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