Dapagliflozin for prednisone‐induced hyperglycaemia in acute exacerbation of chronic obstructive pulmonary disease

• Published in: Diabetes, obesity & metabolism Vol. 20; no. 5; pp. 1306 - 1310
• Main Authors: Gerards, Maaike C., Venema, Gerdien E., Patberg, Kornelis W., Kross, Martijn, Potter van Loon, Bert Jan, Hageman, Ilse M. G., Snijders, Dominic, Brandjes, Dees P.M., Hoekstra, Joost B. L., Vriesendorp, Titia M., Gerdes, Victor E. A.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-05-2018; Wiley Subscription Services, Inc
• Subjects: Aged; Antidiabetics; Benzhydryl Compounds - adverse effects; Benzhydryl Compounds - therapeutic use; Brief Report; Brief Reports; Chronic obstructive pulmonary disease; clinical trial; Combined Modality Therapy - adverse effects; continuous glucose monitoring (CGM); dapagliflozin; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - metabolism; Double-Blind Method; Drug Therapy, Combination - adverse effects; Female; Glucocorticoids - adverse effects; Glucocorticoids - therapeutic use; Glucose - metabolism; Glucose monitoring; Glucosides - adverse effects; Glucosides - therapeutic use; glycaemic control; Humans; Hyperglycemia; Hyperglycemia - chemically induced; Hyperglycemia - drug therapy; hypoglycaemia; Hypoglycemia; Hypoglycemia - chemically induced; Hypoglycemia - prevention & control; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - therapeutic use; Insulin - administration & dosage; Insulin - adverse effects; Insulin - therapeutic use; Insulin Resistance; Length of Stay; Lung diseases; Male; Middle Aged; Monitoring, Ambulatory; Obstructive lung disease; Patients; Prednisone; Prednisone - adverse effects; Prednisone - therapeutic use; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - metabolism; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - therapy; randomized trial; Severity of Illness Index; Sodium-Glucose Transporter 2 Inhibitors - adverse effects; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use; Subcutaneous Tissue - metabolism; clinical trial; continuous glucose monitoring (CGM); glycaemic control; hypoglycaemia; dapagliflozin; randomized trial
• ISSN: 1462-8902; 1463-1326
• DOI: 10.1111/dom.13209

The aim of the present study was to compare the effectiveness and safety of add‐on treatment with dapagliflozin to placebo in patients with prednisone‐induced hyperglycaemia during treatment for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). We enrolled 46 patients hospitalized for an AECOPD in a multicentre double‐blind randomized controlled study in which add‐on treatment with dapagliflozin 10 mg was compared with placebo. Glycaemic control and incidence of hypoglycaemia were measured through a blinded subcutaneous continuous glucose monitoring device. Participants in the dapagliflozin group spent 54 ± 27.7% of the time in target range (3.9–10 mmol/L) and participants in the placebo group spent 53.6 ± 23.4% of the time in target range (P = .96). The mean glucose concentration was 10.1 mmol/L in the dapagliflozin group and 10.4 mmol/L in the placebo group (P = .66). One participant using dapagliflozin and 2 participants using placebo experienced symptomatic hypoglycaemia. Treatment with dapagliflozin was safe and there was no difference in risk of hypoglycaemia compared with placebo. Dapagliflozin did not result in better glycaemic control compared with placebo in participants with prednisone‐induced hyperglycaemia during AECOPD.