The Comparative Study On The Therapeutic Effect And Safety Between Canagliflozin And Metformin In Patients With CVD And T2DM

Objective:To compare the glycemic control,heart-kidney benefit and safety between canagliflozin and metformin.Methods:1.This is a prospective case-control study involving 62 patients with a clear diagnosis of cardiovascular disease and type 2 diabetes,who had poor glycemic control.Explained to them the medicinal properties of canagliflozin and metformin,divided them into the canagliflozin group and the metformin group at random after hospital ethic review and signing informed consent.2.These were observed,Changes in HbA1c,body weight,Scr,SUA,eGFR before and after 3 months’ treatment,the occurrence of MACCE events during 3 months’ treatment,the readmission because of CVD within 3 months and 6 months after beginning therapy and the occurrence of adverse reactions during 3 months’ treatment.Results:1.There was no significant difference in baseline data,including gender,age,history of coronary heart disease,hypertension,stroke and hyperlipidemia,history of smoking,liver function,and fasting fingertip blood glucose on the day of administration,between two groups(P>0.05).2.There was no significant difference in HbA1c between two groups before treatment(P>0.05).There was a statistically significant difference in HbA1c between two groups after treatment(P<0.05).After 3 months of treatment,HbA1c decreased in both two groups compared with that before treatment,and the differences were statistically significant(P < 0.05).There was no significant difference in the Hb A1c’s difference before and after treatment between two groups(P > 0.05),canagliflozin and metformin had same hypoglycemic effect.3.There was no significant difference in the occurrence of MACCE events between two groups during treatment(P>0.05).4.There was no significant difference in the readmission because of CVD between two groups within 3 months after beginning therapy(P>0.05).The readmission rate of CVD in the canagliflozin group was lower than that in the metformin group within 6 months after beginning therapy,and the difference was statistically significant(P<0.05).5.There was no significant difference in body weight between two groups before treatment and after treatment(P >0.05).After 3 months of treatment,body weight decreased in both two groups compared with that before treatment,and the differences were statistically significant(P<0.05).After treatment,the canagliflozin group lost more weight than the metformin group,and the difference was statistically significant(P<0.05).6.There was no significant difference in Scr between two groups before treatment and after treatment(P>0.05).There was no significant difference in Scr between before and after treatment in both two groups(P>0.05).There was no significant difference in the Scr’s difference between two groups(P>0.05),canagliflozin and metformin had no effect on Scr in the short term.7.There was no significant difference in SUA between two groups before treatment and after treatment(P>0.05).The SUA decreased in the canagliflozin group compared with that before treatment,and the difference was statistically significant(P<0.05),there was no significant difference in SUA between before and after treatment in the metformin group(P > 0.05).After treatment,the SUA of the canagliflozin group decreased more than the metformin group,and the difference was statistically significant(P<0.05).8.Screened patients with mild renal injury and normal renal function out,there was no significant difference in eGFR between two groups before treatment and after treatment(P>0.05).There was no significant difference in eGFR between before and after treatment in both two groups(P>0.05).There was no significant difference in the eGFR’s difference between two groups(P>0.05),canagliflozin and metformin had no effect on eGFR in the short term.9.There was no significant difference in the incidence of genitourinary tract infection and hypoglycemia between two groups during treatment(P > 0.05).The incidence of gastrointestinal symptoms in the canagliflozin group was lower than that in the metformin group during treatment,and the difference was statistically significant(P<0.05).Conclusions:1.In the short term,canagliflozin and metformin had same hypoglycemic effect.2.The occurrence of MACCE events and the readmission because of CVD in the canagliflozin group were the same as that in the metformin group.Extending the time of therapy,canagliflozin could reduce the readmission rate of CVD better than metformin.3.Canagliflozin was better than metformin in losing weight.4.Canagliflozin and metformin had no effect on Scr,eGFR of patients with mild renal injury and normal renal function.Canagliflozin could reduce SUA,but metformin had no such effect.5.Compared with metformin,canagliflozin did not increase the incidence of genitourinary tract infection and hypoglycemia,caused fewer gastrointestinal symptoms,so its safety was better than metformin’s.