Canagliflozin Plus Insulin Benefited Diabetes Patients

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In the Canagliflozin Cardiovascular Assessment Study (CANVAS), researchers found that adding canagliflozin (Invokana) to insulin therapy yielded improvements in glycemic control and reduced body weight in patients with type 2 diabetes, according to data published in Diabetes Care.

For the double blind study, the researchers randomly assigned 690 participants with type 2 diabetes to receive placebo, 692 to receive once-daily canagliflozin 100 mg and 690 to receive once-daily canagliflozin 300 mg. Change in HbA1c from baseline to 18 weeks in those using insulin served as the primary endpoint.

Most participants were men (66%), and median age was 63 years. Participants had a mean HbA1c of 8.3%, BMI of 33.1, fasting plasma glucose (FPG) of 9.2 mmol/L, and median daily insulin dose was 60 IU.

At 18 weeks, compared with placebo, HbA1c reductions with canagliflozin 100 mg and 300 mg were –0.62% (95% CI, –0.69 to –0.54) and –0.73% (95% CI, –0.81 to –0.65), respectively. At 52 weeks, reductions were –0.58% (95% CI, –0.68 to –0.48) and –0.73% (95% CI, –0.83 to –0.63), respectively.

The researchers also observed significant reductions in FPG, body weight and blood pressure (BP) at both 18 and 52 weeks. However, both canagliflozin doses were linked to a higher incidence of hypoglycemia, genital mycotic infections and hypovolemia.

Overall, canagliflozin resulted in better glycemic control in patients with type 2 diabetes. Further, although side effects were increased with canagliflozin, they were expected and few led to discontinuation, the researchers concluded. 

Diabetes Rates Leveling Off in Adults
Canagliflozin Plus Insulin Benefited Diabetes Patients

OBJECTIVE: There are limited data about the effects of sodium glucose cotransporter 2 inhibitors when used with insulin. We report the efficacy and safety of canagliflozin in patients with type 2 diabetes using insulin.

RESEARCH DESIGN AND METHODS: The Canagliflozin Cardiovascular Assessment Study is a double-blind, placebo-controlled study that randomized participants to placebo, canagliflozin 100 mg, or canagliflozin 300 mg once daily, added to a range of therapies. The primary end point of this substudy was the change in HbA1c from baseline at 18 weeks among patients using insulin; 52-week effects were also examined.

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