RESUMEN
BACKGROUND AND AIM: To evaluate the effectiveness and safety of a sodium-glucose cotransporter-2 (SGLT-2) inhibitor, dapagliflozin, in patients with type 2 diabetes mellitus (T2DM) and background glucagon-like peptide-1 receptor agonist (GLP1-RA) therapy. METHODS AND RESULTS: This is a 12-month, real-world observational study, which assessed the effectiveness and safety of dapagliflozin in patients with T2DM and background GLP1-RA therapy. The main outcome measures were changes in A1C and weight at 6 and 12 months from baseline. Secondary outcomes were differences in A1C and weight reduction between this cohort and another group of patients with T2DM treated with dapagliflozin but without background GLP1-RA therapy. In total, 109 patients with GLP1-RA and 104 patients without GLP1-RA were included. Baseline mean A1C and weight in the GLP1-RA and non-GLP1-RA groups were 7.4% vs. 7.3% and 96.2 kg vs. 95.1 kg, respectively. A significant reduction in A1C was seen with dapagliflozin in both cohorts at 6 and 12 months (GLP1-RA: -0.51% and -0.34%, non-GLP1-RA: -0.69% and -0.62%, respectively, p < 0.0001 in all analyses). Weight was significantly reduced in both groups at 6 and 12 months (GLP1-RA: -2.3 kg and -2.4 kg, non-GLP1-RA: -3.9 kg and -4.8 kg, respectively, p < 0.0001 in all analyses). A1C reduction and weight loss were significantly lower in patients with GLP1-RA than in patients without GLP1-RAs. Drug discontinuation rates were similar in both cohorts. CONCLUSIONS: Dapagliflozin, when added in real life to patients with T2DM treated with GLP1-RAs, induced a further significant, albeit modest improvement in A1C and a further weight loss.
Asunto(s)
Compuestos de Bencidrilo/uso terapéutico , Glucemia/efectos de los fármacos , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Receptor del Péptido 1 Similar al Glucagón/agonistas , Glucósidos/uso terapéutico , Hipoglucemiantes/uso terapéutico , Incretinas/uso terapéutico , Inhibidores del Cotransportador de Sodio-Glucosa 2 , Anciano , Compuestos de Bencidrilo/efectos adversos , Biomarcadores/sangre , Glucemia/metabolismo , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/diagnóstico , Quimioterapia Combinada , Femenino , Receptor del Péptido 1 Similar al Glucagón/metabolismo , Glucósidos/efectos adversos , Hemoglobina Glucada/metabolismo , Humanos , Hipoglucemiantes/efectos adversos , Incretinas/efectos adversos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Transportador 2 de Sodio-Glucosa/metabolismo , España , Factores de Tiempo , Resultado del Tratamiento , Pérdida de Peso/efectos de los fármacosRESUMEN
Introducción: La utilización de los Servicios deUrgencias de los hospitales ha aumentado de forma llamativaen los últimos años, acudiendo gran parte de los usuariospor iniciativa propia. Ante este problema hemos consideradojustificado realizar este estudio para conocer lasituación de las urgencias hospitalarias en nuestro medio.El objetivo de este estudio es determinar el conocimientodel usuario de los servicios de atención deUrgencias Extrahospitalarias y Puntos de AtenciónContinuada (PAC), así como su motivación para acudir alServicio de Urgencias Hospitalario (SUH) sin consultaprevia en atención primaria.Materiales y métodos: Se elaboró un estudio transversaldescriptivo mediante la realización de un cuestionario adhoc dirigido a una muestra representativa de 200 usuarios delServicio de Urgencias del Hospital de Galdakao-Usansolomayores de 14 años que acudieron sin prescripción médica(P10), es decir, por iniciativa propia, y que fueron atendidosen la zona ambulatoria de dicha urgencia durante los mesesde abril y mayo del 2007.Resultados: Una vez analizados los resultados obtenidosa través de las encuestas, cabe destacar que: a) el 80,51%de los usuarios que las respondieron conoce la existenciade los Servicios de Urgencias de Atención Primaria y PACaunque, por diversos motivos, decidieron acudir al SUH;b) el 79,89% de los usuarios de la muestra pertenecen a losPAC más cercanos al hospital de referencia, Amorebieta Durango, Basauri, y de ellos, la mayoría corresponden alPAC más cercano aún, que es el de Basauri; y c) dentrode los motivos que más alegaron los usuarios para acudiral SUH, aun conociendo la existencia de los PAC, fue laexpectativa de una atención más especializada por losmedios técnicos existentes en un hospital (25,77%), yotros motivos personales (29,38%)...(AU)
Introduction: During the last years, the use of theEmergency Services in hospitals has increased significantly,coming many of these users on their own initiative.The main aim is to determine the users knowledge aboutOut-Of-Hospital Emergency Services and ContinuousAssistance Point (CAP), and their motivation for comingto Hospital Emergency Services without any previous consultationat Primary Assistance.Methodology: Cross-sectional descriptive study bymeans of an ad hoc questionnaire. Representative sampleof 200 users in Emergency Services of Galdakao-UsansoloHospital over 14, who came without any medical prescriptionand were assisted in the clinic zone during April andMay 2007.Results: a) 80,51% of users knew the existence ofPrimary Assistance Emergency Services and CAP, eventhough for different reasons, decided to use HospitalEmergency Services; b) 79,89% of users belong to thenearest CAP from the reference hospital, and most ofthem to the nearest one; y c) one of the most common reasonfor using Hospital Emergency Services, despite knowingthe existence of CAP, was the prospect of more specializedassistance thanks to the technical means existingat the hospital (25,77%), as well as further personal reasons(29,38%).Conclusions: These results suggests that the usersknowledge about the existence of Out-Of-Hospital Emergency Services is wide, although, for different reasons,they dont make use of them. All of this suggeststhat an adequate health education at Primary Assistancelevel is necessary(AU)