South Korea: A recent study compared the therapeutic safety and efficacy of dapagliflozin, sitagliptin, or lobeglitazone adjunct therapy in type 2 diabetes mellitus (T2DM) patients inadequately controlled on metformin and sulfonylurea.
The study by researchers from South Korea revealed that all three drugs showed good glucose-lowering efficacy and comparable safety profiles. Dapagliflozin therapy, however, produced favourable changes in body composition and hence is suggested to be a suitable adjunct therapy for T2DM patients looking to improve their body composition.

Jun Hwa Hong, Eulji University, Daejeon, Republic of Korea, and colleagues aimed to compare the safety and efficacy of dapagliflozin, sitagliptin, and lobeglitazone in patients with uncontrolled type 2 diabetes, despite sulfonylurea and metformin therapy.
In the study, published in Diabetes Research and Clinical Practice, the patients were randomized into three groups, receiving sitagliptin 100 mg, dapagliflozin 10 mg, or lobeglitazone 0.5 mg daily (n = 26 each). The researchers monitored changes in body composition and biochemical parameters for 24 months. Changes in HbA1c at 24 months were calculated as the primary efficacy endpoint.
The study revealed the following findings:
· After 24 months, the mean change in HbA1c in the sitagliptin, dapagliflozin, and lobeglitazone groups was –0.81 ± 0.21%, –1.05 ± 0.70%, and –1.08 ± 0.98%.
· Dapagliflozin treatment significantly lowered systolic blood pressure by 5.5 mmHg and alanine aminotransferase levels.
· Dapagliflozin and lobeglitazone treatment significantly reduced proteinuria and insulin resistance.
· Dapagliflozin reduced whole body fat percentage by 1.2%, whereas sitagliptin and lobeglitazone raised it by 1.1% and 1.8%, respectively.
· In the dapagliflozin group, there was an increase in the whole-body muscle percentage and a decrease in the lobeglitazone group.
· The safety profiles of the three treatments were comparable.
All three drugs -- sitagliptin, dapagliflozin and lobeglitazone -- displayed comparable safety profiles and good glucose-lowering efficacy.
"In terms of urinary protein excretion, blood pressure, and body composition, dapagliflozin therapy demonstrated significant advantages," the researchers wrote in their study.
"Dapagliflozin may be a suitable therapy to improve body composition and cardiometabolic profiles," they concluded.
Reference:
Hwa Hong J, Sung Moon J, Seong K, Lim S. Comparison of therapeutic efficacy and safety of sitagliptin, dapagliflozin, or lobeglitazone adjunct therapy in patients with type 2 diabetes mellitus inadequately controlled on sulfonylurea and metformin: third agent study. Diabetes Res Clin Pract. 2023 Aug 11:110872. doi: 10.1016/j.diabres.2023.110872. Epub ahead of print. PMID: 37574137.