The Effects of Dapagliflozin Therapy on Serum Uric Acid  Levels in Patients of Type 2 Diabetes Mellitus with Hyperuricemia

Authors

  • Ezza Mariam Department of Medicine, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Muhammad Naeem Qureshi Department of Medicine, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Fuad Ahmad Siddiqi Department of Medicine, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Fayyaz Hassan Department of Medicine, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Kanaz Ahmad Siddiqi Department of Medicine, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Laila Yaseen Department of Medicine, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i4.12836

Keywords:

Dapagliflozin, Glucose-Lowering Drugs (GLDs), Hyperuricemia, Type 2 Diabetes Mellitus

Abstract

Objective: To assess the impact of Dapagliflozin on Serum Uric Acid levels in patients of Type-2 Diabetes Mellitus having hyperuricemia.

Study Design: Quasi-Experimental Study.

Place and Duration of Study: Medicine Department of Tertiary Care Hospital Rawalpindi, Pakistan, from Sep 2023 to Sep 2024.

Methodology: In this study, participants were categorized into two different groups. Individuals in Group-A received Dapagliflozin 10 mg/d in conjunction with their standard glucose-lowering medications, while those in Group-B proceeded with regular glucose-lowering medications. Baseline physical examinations, as well as blood samples, were collected from all the subjects of both groups, and then these were performed again after the 12, 24, as well as 48 weeks of treatment.

Results: A total of 250 participants were enrolled in this study. Our study results indicate that after 48 weeks, the mean serum Uric Acid  level decreased significantly by 28.0µmol/L in Group-A, while there was no change in Group-B (0.0 µmol/L), which was statistically significant (p<0.001). For HbA1c levels, the Group-A had a mean reduction of 1.40%, compared to a 1.46% reduction in the glucose-lowering medications group, which was not significant (p=0.47).

Conclusion: Dapagliflozin reduced serum Uric Acid levels in Type 2 Diabetes Mellitus patients with hyperuricemia as opposed to glucose-lowering medication alone.

Downloads

Download data is not yet available.

References

1. Rachdaoui N. Insulin: the friend and the foe in the development of type 2 diabetes mellitus. Int J Mol Sci 2020; 21(5): 1770.

https://doi.org/10.3390/ijms21051770

2. Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract 2022; 183: 109119.

https://doi.org/10.1016/j.diabres.2021.109119

3. Chou MY, Huang ST, Liang CK, Peng LN, Lin YT, Hsiao FY, et al. All-cause mortality, cardiovascular mortality, major cardiovascular events and hypoglycaemia of patients with diabetes onset at an older age: results from the 10-year nationwide cohort study. Age Ageing 2021; 50(6): 2094-2104.

https://doi.org/10.1093/ageing/afab183

4. Gherghina ME, Peride I, Tiglis M, Neagu TP, Niculae A, Checherita IA et al. Uric Acid and oxidative stress—relationship with cardiovascular, metabolic, and renal impairment. Int J Mol Sci 2022; 23(6): 3188.

https://doi.org/10.3390/ijms23063188

5. Anaizi N. The impact of Uric Acid on human health: Beyond gout and kidney stones. Ibnosina J Med Biomed Sci 2023; 15(03): 110-116. https://doi.org/10.1055/s-0043-1770929

6. Tian X, Wang A, Zuo Y, Chen S, Zhang L, Zhao Y, et al. Time course of serum Uric Acid accumulation and the risk of diabetes mellitus. Nutr Diabetes 2022; 12(1): 1.

https://doi.org/10.1038/s41387-021-00179-8

7. Hussain M, Elahi A, Hussain A, Iqbal J, Akhtar L, Majid A et al. Sodium‐glucose cotransporter‐2 (SGLT‐2) attenuates serum Uric Acid (SUA) level in patients with type 2 diabetes. J Diabetes Res 2021; 2021(1): 9973862.

https://doi.org/10.1155/2021/9973862

8. Han T, Meng X, Shan R, Zi T, Li Y, Ma H, et al. Temporal relationship between hyperuricemia and obesity, and its association with future risk of type 2 diabetes. Int J Obes 2018; 42(7): 1336-44.

https://doi.org/10.1038/s41366-018-0074-5

9. Krishnan E, Pandya BJ, Chung L, Hariri A, Dabbous O. Hyperuricemia in young adults and risk of insulin resistance, prediabetes, and diabetes: a 15-year follow-up study. Am J Epidemiol 2012; 176(2): 108-116.

https://doi.org/10.1093/aje/kws002

10. Fioretto P, Giaccari A, Sesti G. Efficacy and safety of Dapagliflozin, a sodium glucose cotransporter 2 (SGLT2) inhibitor, in diabetes mellitus. Cardiovasc Diabetol 2015; 14(1): 1-3. https://doi.org/10.1186/s12933-015-0297-x

11. Alqahtani SA, Awan ZA, Alasmary MY, Al Amoudi SM. Association between serum Uric Acid with diabetes and other biochemical markers. J Family Med Prim Care 2022; 11(4): 1401-1419.

https://doi.org/10.4103/jfmpc.jfmpc_1833_21

12. Cheng L, Fu Q, Zhou L, Fan Y, Liu F, Fan Y, et al. Dapagliflozin, metformin, monotherapy or both in patients with metabolic syndrome. Sci Rep 2021; 11(1): 24263.

https://doi.org/10.1038/s41598-021-03773-z

13. Lee SH, Min KW, Lee BW, Jeong IK, Yoo SJ, Kwon HS, et al. Effect of Dapagliflozin as an add-on therapy to insulin on the glycemic variability in subjects with type 2 diabetes mellitus (DIVE): a multicenter, placebo-controlled, double-blind, randomized study. Diabetes Metab J 2021; 45(3): 339-348.

https://doi.org/10.4093/dmj.2019.0203

14. Nikolic M, Zivkovic V, Jovic JJ, Sretenovic J, Davidovic G, Simovic S, et al. SGLT2 inhibitors: a focus on cardiac benefits and potential mechanisms. Heart Fail Rev 2021; 3: 1-5.

https://doi.org/10.1007/s10741-021-10079-9

15. Jabbour SA, Hardy E, Sugg J, Parikh S. Dapagliflozin is effective as add-on therapy to sitagliptin with or without metformin: a 24-week, multicenter, randomized, double-blind, placebo-controlled study. Diabetes Care 2014; 37(3): 740-750.

https://doi.org/10.2337/dc13-0467

16. Strojek K, Yoon KH, Hruba V, Elze M, Langkilde AM, Parikh S et al. Effect of Dapagliflozin in patients with type 2 diabetes who have inadequate glycaemic control with glimepiride: a randomized, 24‐week, double‐blind, placebo‐controlled trial. Diabetes Obes Metab 2011; 13(10): 928-938.

https://doi.org/10.1111/j.1463-1326.2011.01434.x

17. Bailey CJ, Gross JL, Hennicken D, Iqbal N, Mansfield TA, List JF et al. Dapagliflozin add-on to metformin in type 2 diabetes inadequately controlled with metformin: a randomized, double-blind, placebo-controlled 102-week trial. BMC Med 2013; 11: 43.

https://doi.org/10.1186/1741-7015-11-43

18. Akbari A, Rafiee M, Sathyapalan T, Sahebkar A. Impacts of sodium/glucose Cotransporter‐2 inhibitors on circulating Uric Acid concentrations: a systematic review and meta‐analysis. J Diabetes Res 2022; 2022(1): 7520632.

https://doi.org/10.1155/2022/7520632

19. Zhao Y, Xu L, Tian D, Xia P, Zheng H, Wang L, et al. Effects of sodium‐glucose co‐transporter 2 (SGLT2) inhibitors on serum Uric Acid level: a meta‐analysis of randomized controlled trials. Diabetes Obes Metab 2018; 20(2): 458-462.

https://doi.org/10.1111/dom.13101

20. Xin Y, Guo Y, Li Y, Ma Y, Li L, Jiang H et al . Effects of sodium glucose cotransporter-2 inhibitors on serum Uric Acid in type 2 diabetes mellitus: A systematic review with an indirect comparison meta-analysis. Saudi J Biol Sci 2019; 26(2): 421-426.

https://doi.org/10.1016/j.sjbs.2018.11.013

Downloads

Published

30-08-2025

Issue

Section

Original Articles

Categories

How to Cite

1.
Mariam E, Qureshi MN, Siddiqi FA, Hassan F, Siddiqi KA, Yaseen L. The Effects of Dapagliflozin Therapy on Serum Uric Acid  Levels in Patients of Type 2 Diabetes Mellitus with Hyperuricemia. Pak Armed Forces Med J [Internet]. 2025 Aug. 30 [cited 2025 Sep. 5];75(4):747-51. Available from: https://pafmj.org/PAFMJ/article/view/12836