Stratification of SGLT2 inhibitor glucose lowering therapy in Type 2 diabetes

Type 2 diabetes affects over 350 million people. Good control of blood glucose (sugar) with appropriate lifestyle and medication helps patients feel better and reduces the risks of developing diabetes complications. Current guidelines for treating patients with Type 2 diabetes list a large number of drugs without giving clear guidance on which patients should have which drug. This makes it difficult for patients and their health care professionals to know which drugs are likely to suit them best. We know that patients with Type 2 diabetes vary greatly in how well they respond to different diabetes drugs, and whether they develop side effects.
Aim
The aim of this research is to identify clinical characteristics (such as weight or blood test results) that predict HbA1c change and side effects for glucose lowering treatments called sodium–glucose cotransporter 2 inhibitors (SGLT2I). The ultimate aim is to help doctors treat patients with Type 2 diabetes with the drug most likely to work well for them.
Objectives
Our objectives are to:
1. Identify if kidney function is associated with glucose lowering response to SGLT2I treatment
2. Identify whether clinical characteristics and blood tests associated with insulin secretion and insulin resistance are associated with glucose lowering response
3. Determine whether patients with higher glucose, and better glucose lowering response, have more side effects
4. Explore what other characteristics might help predict glucose lowering and side effects with SGLT2I
How will this research be conducted?
This research forms part of a larger national project funded by the UK government Medical Research Council, called MASTERMIND. In this study we will use information from 7 large studies where SGLT2 inhibitor treatment or comparison treatment has been previously tested in over 7000 people with Type 2 diabetes. We will test whether differences between people in these studies (for example their age, weight, or common blood test results such as kidney function) can be used to identify those who are likely to have a large reduction in blood glucose with these treatments and/or have a low risk of side effects.
We will compare results from this study with findings from other studies we are undertaking, for example other drug trials and information from patients taking these tablets as part of their normal care, so that we can be sure our findings are true and accurate. Further work to help us interpret these findings will include assessment of the potential benefits and disadvantages of targeting treatment in this way, through ongoing research in the MASTERMIND project.

How will our findings be communicated to patients and the public?
We will work with the charity Diabetes UK to communicate this research via their website, patient newsletter and social media. We will also communicate findings through presentations to patient groups and for important findings though local and national media.