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Effectiveness of dapagliflozin on vascular endothelial function and glycemic control in patients with early-stage type 2 diabetes mellitus: DEFENCE study

Overview of attention for article published in Cardiovascular Diabetology, July 2017
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Title
Effectiveness of dapagliflozin on vascular endothelial function and glycemic control in patients with early-stage type 2 diabetes mellitus: DEFENCE study
Published in
Cardiovascular Diabetology, July 2017
DOI 10.1186/s12933-017-0564-0
Pubmed ID
Authors

Fumika Shigiyama, Naoki Kumashiro, Masahiko Miyagi, Kayoko Ikehara, Eiichiro Kanda, Hiroshi Uchino, Takahisa Hirose

Abstract

Recent studies reported that sodium glucose cotransporter 2 (SGLT2) inhibitors can potentially reduce the risk of cardiovascular mortality in patients with type 2 diabetes mellitus (T2DM). However, there is little or no information on the therapeutic effects of SGLT2 inhibitors on the progression of atherosclerosis. This dapagliflozin effectiveness on vascular endothelial function and glycemic control (DEFENCE) study was designed to determine the effects of dapagliflozin, a SGLT2 inhibitor, on endothelial function in patients with early-stage T2DM. DEFENCE is a prospective, randomized, open-label, blinded-endpoint, parallel-group, comparative clinical trial. Between October 2015 and August 2016, 80 T2DM patients treated with 750 mg of metformin (hemoglobin A1c ≥6.0 and <8.0%, n = 80) were enrolled and randomized to receive either 1500 mg/day metformin (the metformin group, n = 40), or 750 mg/day metformin supplemented with 5 mg/day dapagliflozin (the dapagliflozin group, n = 40), for 16 weeks. The primary endpoint was a change in flow-mediated dilation (FMD) from baseline to the end of the 16-week treatment period. The secondary outcomes include changes in indexes of glycemic control, lipid metabolism, and oxidative stress, body composition, and safety evaluation. Although FMD tended to improve only in the dapagliflozin group, ΔFMD was comparable between the two groups. Analysis of patients with HbA1c >7.0% showed significant improvement of FMD in the dapagliflozin group than metformin group (P < 0.05). HbA1c, fasting plasma glucose, plasma glucagon, and body weight significantly decreased in both groups. Interestingly, urine 8-hydroxy-2'-deoxyguanosin, a biomarker of oxidative stress, was significantly lower in the dapagliflozin group than metformin group at 16 weeks (P < 0.001). Dapagliflozin add-on therapy to metformin for 16 weeks improved endothelial function, as assessed by FMD, in patients with inadequately controlled early-stage T2DM. Improvement in oxidative stress may contribute to the improvement in FMD. Trial registration University Hospital Medical Information Network Clinical Trial Registry (UMIN000018754).

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 198 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 198 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 25 13%
Other 17 9%
Researcher 17 9%
Student > Bachelor 17 9%
Student > Postgraduate 15 8%
Other 46 23%
Unknown 61 31%
Readers by discipline Count As %
Medicine and Dentistry 78 39%
Biochemistry, Genetics and Molecular Biology 11 6%
Nursing and Health Professions 11 6%
Pharmacology, Toxicology and Pharmaceutical Science 8 4%
Agricultural and Biological Sciences 4 2%
Other 14 7%
Unknown 72 36%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 July 2017.
All research outputs
#17,861,715
of 20,141,442 outputs
Outputs from Cardiovascular Diabetology
#990
of 1,151 outputs
Outputs of similar age
#241,578
of 280,680 outputs
Outputs of similar age from Cardiovascular Diabetology
#1
of 1 outputs
Altmetric has tracked 20,141,442 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,151 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.3. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
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