MARCIA A. TESTA and DONALD C. SIMONSON, Boston, MA

Gender Differences in Diabetes Distress Comparing Dapagliflozin plus Saxagliptin to Glimepiride When Added to Metformin in Poorly Controlled Type 2 Diabetes

Author Block: MARCIA A. TESTA, DONALD C. SIMONSON, Boston, MA
Distress due to diabetes symptoms and medication side effects is distinct from psychological disorders and can interfere with A1C control and quality of life (QOL). We analyzed patient-reported outcomes (PRO) during a double-blind, 156-wk randomized clinical trial to evaluate effects of gender and treatment on diabetes distress in T2D patients (A1C, 7.5-10.5%) receiving stable metformin (M) ≥1500 mg/d and assigned to either dual add-on therapy with dapagliflozin (D) 10 mg/d + saxagliptin (S) 5 mg/d (n = 227) or single add-on glimepiride (G) titrated 1-6 mg/d (n = 216). A1C, weight and PRO (353 items) were assessed at baseline and wks 12, 28, 52, 104 and 156, and analyzed using linear mixed-effects models. At wk 52, D+S+M resulted in greater reductions in A1C (-1.4±0.1 vs. -1.0±0.1%) and weight (-3.1±0.3 vs. 1.0±0.3 kg) vs. G+M (p<0.001) that remained lower through wk 156. Men had lower A1C at each visit vs. women (all p<0.05). Distress scores (0-100) due to weight gain for D+S+M vs. G+M (83.0±0.8 vs. 75.4±0.9), weight concern (59.9±1.3 vs. 52.5±1.4) and being overweight (40.6±1.2 vs. 44.8±1.2) all favored D+S+M (p<0.01). Model interactions showed that women vs. men experienced greater distress (p = 0.01) that interfered with work, role and daily activities (p<0.001) on G+M compared to D+S+M. Mental health (p = 0.11) and health perceptions (p = 0.59) did not show treatment differences. QOL ratings for women favored D+S+M (p<0.01). Overall satisfaction (78.4±0.3 vs. 76.7±0.3, p<0.001) favored D+S+M, as did subscales of work/role, effectiveness, side effects, burden, preference, net benefit, and regimen acceptance (all p<0.05). Women showed greater improvements in treatment satisfaction compared to men. While addressing diabetes distress to improve a patient’s well-being is important, ameliorating diabetes distress related to medication side effects such as weight gain may also lead to improved adherence, self-care and glycemic control.

To view this abstract on the American Diabetes Association Website, Click Here – Abstract 799-P

To view the e-poster on the American Diabetes Association Website, Click Here – ePoster  799-P