- This new analysis of the DAPA-HF trial suggests that sodium-glucose cotransporter 2 inhibitor dapagliflozin reduces the relative incidence of new-onset type 2 diabetes (T2D) by almost a third in patients with heart failure with reduced ejection fraction (HFrEF).
- Daily treatment reduces the risk by 32%.
Why this matters
- Findings indicate that diabetes prevention could be considered an additional benefit of dapagliflozin, whose main effect is to lower cardiovascular mortality and worsening of heart failure in patients with HFrEF.
- DAPA-HF was a phase 3 placebo-controlled trial involving 4744 patients with HFrEF.
- This exploratory analysis of DAPA-HF evaluated whether dapagliflozin reduced T2D incidence in 2605 trial patients without T2D.
- Patients were randomly assigned to receive dapagliflozin 10 mg (n=1298) or placebo (n=1307) and followed for a median of 18.2 months.
- New-onset T2D was defined as glycated hemoglobin (HbA1C) of ≥6.5% on 2 consecutive study visits.
- Funding: AstraZeneca.
- A total of 157 patients developed T2D, of whom 150 (95.5%) had prediabetes (HbA1C, 5.7%-6.4%).
- Patients who developed T2D vs those who remained nondiabetic had a higher:
- mean baseline HbA1C (6.2±0.3 vs 5.7±0.4%; P<.001>
- greater body mass index (28.5±5.9 vs 27.1±5.7 kg/m2; P=.003); and
- lower estimated glomerular filtration rate (61.5±17.4 vs 68.2±19.3 mL/min/1.73 m2; P<.001>
- Short follow-up duration.