A Real-world Comparative Analysis of DPP-4 Inhibitors Versus SGLT2 Inhibitors in Type 2 Diabetes Mellitus

Background: Diabetes has steadily increased in India over the last three decades, with 77 million people having diabetes as of 2019, which is expected to rise to 134 million by 2045.Over 90 % of these cases are of type 2 diabetes.The newer antidiabetics like dipeptidyl peptidase IV (DPP-IV) inhibitors and sodium-glucose transporter-2 (SGLT-2) inhibitors are prescribed nowadays in type 2 diabetic patients.However, the relative efficacy and safety of these two new drug groups are unknown.Objectives: We conducted this study to evaluate the efficacy and safety of DPP-IV inhibitors and SGLT-2 inhibitors as add-on therapies in type 2 diabetic patients attending a tertiary care teaching hospital.Methods: This was a prospective, observational, comparative study conducted at GCS hospital, Ahmedabad, India, from November 2020 to October 2022. Results:In this study, 125 patients of either gender were enrolled and analysed.Of the 125 patients, 82 have been prescribed DPP-IV inhibitors (65.6%), and 43 were prescribed SGLT-2 inhibitors (34.4 %).SGLT-2 inhibitors had a more substantial decrease in HbA1c than DPP-IV inhibitors at weeks 12 (-1.13±1.33 vs -0.39±1.40,P<0.05) and 24 (-1.87±1.74vs -1.07±1.58,P<0.05).The total number of adverse events was lower in the DPP-IV inhibitor group than in the SGLT 2 inhibitor group (18.3% vs 46.5%).Urinary tract infection was the most common adverse event in the SGLT-2 inhibitor group.While in the DPP-IV inhibitor group, gastrointestinal adverse events were common.Conclusion: Though SGLT-2 inhibitors have shown better efficacy outcomes, their possible adverse drug reactions should be kept in mind by physicians.