Vincent Woo

University of Manitoba

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Lawrence A. Leiter

St. Michael's Hospital

Jean‐François Yale

Ste. Anne's Hospital

Chantal Mathieu

KU Leuven

Ronald Goldenberg

LMC Diabetes & Endocrinology (Canada)

Lori Berard

University of Winnipeg

Sheldon W. Tobe

Health Sciences Centre

Bernard Zinman

University of Toronto

Simon Heller

University of Sheffield

Maureen Clement

University of British Columbia

Irene Hramiak

Western University

Cooperative Institutions

University of Toronto

228

Society of Interventional Radiology

125

University of British Columbia

118

McMaster University

107

Université de Montréal

103

Novo Nordisk (Denmark)

102

University of Ottawa

100

Ibero American University

University of Calgary

University of Alberta

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Abstract 9520: Dapagliflozin, a Novel Antihyperglycemic Agent that Promotes Urinary Glucose Excretion, Reduces Systolic Blood Pressure in Patients with Type 2 Diabetes Mellitus

Circulation (2011)

Vincent Woo Anna Maria Langkilde Jennifer Sugg Shamik Parikh

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.

Dapagliflozin

10.1161/circ.124.suppl_21.a9520

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Citations (8)

Fast-Acting Insulin Aspart Improves Glycemic Control in Basal-Bolus Treatment for Type 1 Diabetes: Results of a 26-Week Multicenter, Active-Controlled, Treat-to-Target, Randomized, Parallel-Group Trial (onset 1)

Diabetes Care (2017)

David Russell‐Jones Bruce W. Bode Christophe De Block Edward Franek Simon Heller

OBJECTIVE This multicenter, treat-to-target, phase 3 trial evaluated the efficacy and safety of fast-acting insulin aspart (faster aspart) versus conventional insulin aspart (IAsp) in adults with type 1 diabetes. RESEARCH DESIGN AND METHODS The primary end point was change from baseline in HbA1c after 26 weeks. After an 8-week run-in, subjects were randomized (1:1:1) to double-blind mealtime faster aspart (n = 381), IAsp (n = 380), or open-label postmeal faster aspart (n = 382)—each with insulin detemir. RESULTS HbA1c was reduced in both treatment groups, and noninferiority to IAsp was confirmed for both mealtime and postmeal faster aspart (estimated treatment difference [ETD] faster aspart–IAsp, mealtime, –0.15% [95% CI –0.23; –0.07], and postmeal, 0.04% [–0.04; 0.12]); mealtime faster aspart statistically significantly reduced HbA1c versus IAsp (P = 0.0003). Postprandial plasma glucose (PPG) increments were statistically significantly lower with mealtime faster aspart at 1 h (ETD –1.18 mmol/L [95% CI –1.65; –0.71], –21.21 mg/dL [–29.65; –12.77]; P < 0.0001) and 2 h (–0.67 mmol/L [–1.29; –0.04], –12.01 mg/dL [–23.33; –0.70]; P = 0.0375) after the meal test; superiority to IAsp for the 2-h PPG increment was confirmed. The overall rate of severe or blood glucose–confirmed (plasma glucose <3.1 mmol/L [56 mg/dL]) hypoglycemic episodes and safety profiles were similar between treatments. CONCLUSIONS Faster aspart effectively improved HbA1c, and noninferiority to IAsp was confirmed, with superior PPG control for mealtime faster aspart versus IAsp. Subjects randomized to postmeal faster aspart for all meals maintained HbA1c noninferior to that obtained with mealtime IAsp.

Insulin aspart

Insulin detemir

Clinical endpoint

Crossover study

10.2337/dc16-1771

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Citations (158)

Dosing Irregularities and Self-Treated Hypoglycemia in Type 2 Diabetes: Results from the Canadian Cohort of an International Survey of Patients and Healthcare Professionals

Canadian Journal of Diabetes (2015)

Lawrence A. Leiter Damir Boras Vincent Woo

Health Professionals

10.1016/j.jcjd.2015.09.085

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Citations (7)

Diabetes and Driving

Canadian Journal of Diabetes (2018)

Robyn L. Houlden Lori Berard Joshua Lakoff Vincent Woo Jean‐François Yale

Glucose meter

Blood glucose monitoring

Insulin pump

Blood Glucose Self-Monitoring

10.1016/j.jcjd.2017.10.018

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Citations (15)

Efficacy and Safety of Fast-acting Insulin Aspart Are Maintained over 52 weeks: Comparison with Insulin Aspart in Onset 1

Canadian Journal of Diabetes (2017)

Vincent Woo Chantal Mathieu Bruce W. Bode Edward Franek Athena Philis‐Tsimikas

Insulin aspart

Insulin detemir

10.1016/j.jcjd.2017.08.152

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Citations (1)

117 - Diabetes Duration Did Not Moderate Severe Hypoglycemia Seen With Glargine U100 vs Degludec in DEVOTE

Canadian Journal of Diabetes (2019)

Vincent Woo Kajsa Kvist John B. Buse ELISE HACHMANN-NIELSEN Anastasia‐Stefania Alexopoulos

Insulin degludec

Insulin detemir

10.1016/j.jcjd.2019.07.126

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Semaglutide Provides Superior Body Weight Reduction Across Sustain 1–5 Clinical Trials

International Journal of Nutrology (2018)

Emanuela Cavalari Ildiko Lingvay J Lüdemann Michel Marre Kari Uusinarkaus

Semaglutide

10.1055/s-0038-1675018

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Pharmacothérapie du diabète de type 2

Canadian Journal of Diabetes (2013)

William Harper Maureen Clement Ronald Goldenberg Amir Hanna Andrea Main

10.1016/j.jcjd.2013.07.006

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Citations (1)

Relationship between Weight Change Patterns and Health Satisfaction in the CANadian Canagliflozin Registry (CanCARE) Study

Diabetes (2018)

Vincent Woo Harpreet S. Bajaj Maureen Clement Fernando Camacho Shana Traina

Patient health satisfaction is associated with positive health behaviors and is considered important for optimal management of type 2 diabetes mellitus (T2DM). In previously reported randomized clinical trials (RCTs) of canagliflozin (CANA), CANA reduced HbA1c, body weight, and blood pressure. CanCARE is a prospective, observational, 12-month registry for people living with T2DM newly initiated on CANA. The Current Health Satisfaction Questionnaire (CHES-Q) was administered in this study at baseline (BL) and repeated at 3, 6 and 12 months. We report the pre-specified analyses investigating the relationship between current health satisfaction agreement on CHES-Q with weight change patterns defined as: Pattern 1 (loss from BL to month 3 and loss from month 3 to 12); Pattern 2 (loss from BL to month 3 and gain from month 3 to 12); Pattern 3 (gain from BL to month 3 and loss from month 3 to 12); and Pattern 4 (gain from BL to month 12). At month 12, 75.4% of subjects (389/516) completed the CHES-Q, of which 318 patients, with available data, had a mean weight loss of 3.2 kg (7.1 lbs). Proportion of subjects with weight loss patterns were: 55.5%, 25.5%, 13.2% and 4.8% for patterns 1, 2, 3, and 4, respectively. Satisfaction agreement with current health increased from 46.5% to 67.9%, 52.5% to 63.9%, 40.0% to 44.7%, and 20.0% to 26.7% within weight loss patterns 1, 2, 3, and 4, respectively. Based on 290 subjects with available data, 64.2%, 65.3% and 60.5% in patterns 1, 2, and 3 reported satisfaction agreement maintenance or improvement with current health between baseline and month 12; with relatively less maintenance or improvement (46.7%) among those with Pattern 4 (weight gain). This analysis shows that real world use of CANA offers weight loss consistent with that seen in CANA RCTs and suggests a direct correlation between weight change patterns and health satisfaction for people living with T2DM. Disclosure V.C. Woo: Advisory Panel; Self; Janssen Pharmaceuticals, Inc., AstraZeneca, Novo Nordisk Inc., Sanofi, Boehringer Ingelheim Pharmaceuticals, Inc., Merck & Co., Inc. H.S. Bajaj: Speaker's Bureau; Self; Abbott. Advisory Panel; Self; Amgen Inc.. Speaker's Bureau; Self; Amgen Inc.. Advisory Panel; Self; AstraZeneca. Consultant; Self; AstraZeneca. Research Support; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca, Bayer AG. Advisory Panel; Self; Boehringer Ingelheim GmbH. Research Support; Self; Boehringer Ingelheim GmbH. Speaker's Bureau; Self; Boehringer Ingelheim GmbH. Advisory Panel; Self; Eli Lilly and Company. Research Support; Self; Eli Lilly and Company. Speaker's Bureau; Self; Eli Lilly and Company. Advisory Panel; Self; Janssen Pharmaceuticals, Inc.. Research Support; Self; Janssen Pharmaceuticals, Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc., Medtronic. Advisory Panel; Self; Merck & Co., Inc.. Research Support; Self; Merck & Co., Inc.. Speaker's Bureau; Self; Merck & Co., Inc., Mylan. Advisory Panel; Self; Novo Nordisk Inc.. Research Support; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Novo Nordisk Inc.. Advisory Panel; Self; Sanofi. Research Support; Self; Sanofi. Speaker's Bureau; Self; Sanofi. Advisory Panel; Self; Valeant Pharmaceuticals International, Inc.. Research Support; Self; Valeant Pharmaceuticals International, Inc.. Speaker's Bureau; Self; Valeant Pharmaceuticals International, Inc. M.A. Clement: Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc., AstraZeneca, Novo Nordisk Inc., Sanofi-Aventis, Eli Lilly and Company. F. Camacho: Consultant; Self; Janssen Inc. S. Traina: Employee; Self; Janssen Global Services, LLC. N. Georgijev: Employee; Self; Janssen Scientific Affairs, LLC. J.B. Rose: Employee; Self; Janssen Pharmaceuticals, Inc. D. Sorabji: Employee; Self; Janssen Pharmaceuticals, Inc. A.D. Bell: Advisory Panel; Self; AstraZeneca, Janssen Pharmaceuticals, Inc., Bayer AG, Eli Lilly and Company, Novo Nordisk Inc.. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Servier.

Canagliflozin

Weight change

10.2337/db18-821-p

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Citations (0)

The 2007 Canadian Hypertension Education Program recommendations for the management of hypertension: Part 2 – therapy

Canadian Journal of Cardiology (2007)

Nadia Khan Brenda R. Hemmelgarn Raj Padwal Pierre Larochelle Jeff Mahon

10.1016/s0828-282x(07)70798-5

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Citations (109)