Abstract 9520: Dapagliflozin, a Novel Antihyperglycemic Agent that Promotes Urinary Glucose Excretion, Reduces Systolic Blood Pressure in Patients with Type 2 Diabetes Mellitus
Bibliographic record
Abstract
Background: Obesity and hypertension commonly occur in patients with type 2 diabetes mellitus (T2DM). Dapagliflozin (DAPA), a selective inhibitor of sodium-glucose cotransporter 2 (SGLT2), reduces hyperglycemia in T2DM by increasing urinary glucose excretion leading to osmotic diuresis, caloric loss, and weight loss. Using prospective exploratory analyses from 3 Phase III studies in patients with T2DM, we evaluated whether DAPA also reduces blood pressure (BP). Methods: Seated systolic and diastolic BP, heart rate, proportion of patients with measured orthostatic hypotension, and adverse events of hypotension, dehydration or hypovolemia were assessed in each study. Study 1 ( NCT00660907 ): randomized to DAPA or glipizide added to open-label metformin; both treatments were up-titrated, based on tolerability and glycemic response, to a maximum of 10 mg/day or 20 mg/day, respectively. Study 2 ( NCT00680745 ): randomized to DAPA 2.5, 5, or 10 mg or placebo added to open-label glimepiride. Study 3 ( NCT00673231 ): randomized to DAPA 2.5, 5, or 10 mg or placebo added to open-label insulin ± oral antidiabetic agents. Use of anti-hypertensive medication was not controlled in these studies. Results: DAPA reduced mean systolic BP, and to a lesser extent diastolic BP (Table), without increasing mean heart rate or proportions of patients experiencing orthostatic hypotension. Adverse events of hypotension, dehydration or hypovolemia were reported in 1.5%, 0.4%, and 1.6% of patients receiving DAPA vs 0.7%, 0%, and 1% receiving glipizide or placebo in studies 1, 2 and 3, respectively. These episodes were of mild or moderate intensity and none led to study discontinuation or hospitalization. Conclusions: DAPA modestly reduces systolic BP in patients with T2DM who were mostly receiving treatment for hypertension. Further studies employing controlled antihypertensive therapy are required to validate the BP-lowering effect of dapagliflozin in T2DM patients with hypertension.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.012 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".