The influence of dapagliflosin on adherence to complex treatment of cardiometabolic patients with type 2 diabetes mellitus

Abstract

Introduction. Among patients with cardiovascular disease, comorbid patients with various combinations of cardiometabolic syndrome prevalence and need life-long treatment. Polypharmacy, expensiveness and side effects caused by it are the main reasons for low adherence to treatment and reducing its effectiveness, that resulted in searching drugs with multiple actions and physiological effects. Purpose of the study. To study the influence of sodium-glucose co-transporter-2 (SGLT-2) inhibitor dapagliflozin in complex treatment of comorbid cardiometabolic patients and their adherence in outpatient’s treatment. Material and Methods. The dynamics of the health status and treatment of 26 patients with type 2 diabetes mellitus with overweight or obesity, hypertension before and during dapagliflozin intake in the standard single daily dose of 10 mg in complex treatment were analyzed. Along with a general clinical examination the condition of the cardiovascular system and kidneys, glucose, lipid, purine and potassium profile were studied. Self-assessment of the state of health and quality of life, adherence to treatment were assessed by a verbal survey and on the regularity of monthly online contacts at the initiative of patients without reminders. Results of the study. Gradual improvement in the state of the cardiovascular system and the functional capacity of the kidneys in all patients were observed. Patients were noted that it was easier to lose weight than previously. The improvement of health indicators, as well as patients' self-assessment of their condition and quality of life, occurred against the background of a gradual decrease in the number or dose of antihypertensive, hypouricemic and diuretic drugs. This may also be one of the factors in improving treatment adherence – if at the beginning of observation all 26 patients assessed their condition as unsatisfactory, then after a year of treatment everyone notes its improvement (14 feel satisfactory, and 12 feel good). None required inpatient treatment. Conclusion. Dapagliflozin in the standard single daily dose of 10 mg leads to reduction of metabolically active obesity, normalization of blood pressure, reduces the symptoms of heart failure, improves the functional capacity of the kidneys in patients with type 2 diabetes mellitus with overweight or obesity and hypertension, and can be recommended as a first-line antidiabetic drug for such patients. Inclusion of dapagliflozin in complex treatment of patients with cardiometabolic multimorbidity has positive impact on their adherence to long-term treatment, which contributes to increasing its effectiveness, reducing the risk of hospitalization, and therefore the cost.