Relationship Between Canagliflozin Treatment Response And Duration Of Diabetes: The Association Of British Clinical Diabetologists (Abcd) Nationwide Canagliflozin Audit

In the ABCD nationwide liraglutide audit the impact of liraglutide on HbA1c was found to lessen with increasing duration of diabetes (abstract 1038-P, ADA 2012). We were interested to examine the relationship between change in HbA1c and duration of diabetes in response to canagliflozin in real clinical use in the ABCD nationwide canagliflozin audit. By December 2018 the audit had accumulated data on 972 canagliflozin treated patients of whom there were 604 with baseline HbA1c ≥ 7% and follow-up HbA1c (mean ± SD age 60.3 ± 11.1 year, BMI 33.7 ± 6.7 kg/m2, 62% male, median (IQR) diabetes duration 6.0 (2.6-11) year). By 1st return to clinic after commencing canagliflozin at median (IQR) 4.1 (3.0-6.1) months, mean ± SD HbA1c fell by 0.91 ± 1.2%, from 9.2 ± 1.5 to 8.3 ± 1.3% (p<0.001). Patients with duration of diabetes data (n=434) were divided into 3 groups: 0-5, 6-10, >10 years with mean ± SD baseline HbA1c 9.1 ± 1.6, 9.2 ± 1.5 and 9.3 ± 1.3% respectively (p=0.62). The mean ± SD falls in HbA1c for the 3 groups were 0.87 ± 1.3%, 0.88 ± 1.2%, and 0.86 ± 1.2%, respectfully (p=0.99) (Figure). There was thus no relationship between duration of diabetes and fall in HbA1c in this audit of canagliflozin in real clinical use in the UK. This result contrasts with that from the ABCD liraglutide audit and is in keeping with the differing modes of action of liraglutide and canagliflozin. Disclosure R.E.J. Ryder: Advisory Panel; Self; Novo Nordisk A/S. Speaker's Bureau; Self; Bioquest. S.M. Phillips: None. A. Evans: None. D.K. Sennik: Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Sanofi. A. Rohilla: None. A. Bickerton: Employee; Self; MyWay Digital Health. K. Thong: None. M. Yadagiri: None. M.L. Cull: None. M.C. Wyres: None. P. Winocour: None. K.H. Darzy: None. A. Strzelecka: None. S.G. Gohil: None. A. Gallagher: Speaker's Bureau; Self; Novo Nordisk A/S. I.W. Gallen: None. Funding Association of British Clinical Diabetologists