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Glycemic Efficacy of Canagliflozin (CANA) by Baseline A1C and Known Duration of Type 2 Diabetes Mellitus (T2DM)
Abstracts / Can J Diabetes 38 (2014) S29eS74
8% fitting DM diagnosis. A total of 64% had a diagnosis of established DM or potentially newly diagnosed DM or prediabetes.
118 A Cross-Sectional Survey of Cardiometabolic Risk Factors in Canadian Primary Care Patients with Abdominal Obesity DAVID C.W. LAU*y, LAWRENCE A. LEITERy, JACQUES J.G. GENEST JR.y, STEWART B. HARRISy, PETER SELBYy, VALERIE TAYLORy, MAJA BUJASBOBANOVICy, JOHN STEWARTy Calgary, AB; Toronto, ON; Montreal, QC; London, ON; Paris, France; Laval, QC The objectives of this cross-sectional study were to evaluate the prevalence as well as the management of cardiometabolic risk factors (CMRFs) in overweight/obese Canadians. Subjects with increased body mass index (BMI >27 kg/m2 )/waist circumference (WC >94 cm in men, >80 cm in women) were recruited by 468 primary care physicians across Canada (37% from Ontario, 28% from Quebec and 35% from other provinces), and evaluated during a single clinic visit. In addition, the following risk factors were also assessed: hypertension (SBP >130 and/or DBP >80), dysglycemia (IGT or diabetes), low HDL-C (<1 in men or <1.3 mmol/L in women), triglycerides >1.7 mmol/L, LDL-C >3.5 mmol/L or >2 with cardiovascular event, and smoking status. A total of 9985 subjects were included in the analysis: mean age 58 years, M/F (52%/48%), mean BMI 33.2 and 34.0 kg/m2, mean WC 113.2 cm and 106.4 cm, for men and women, respectively. Women had a median of 3 CMRFs while men had a median of 4 CMRFs. 70% of the subjects had additional CMRFs with the following prevalence: high LDL-C (81.9%), hypertriglyceridemia (69.8%), hypertension (67.2%), low HDL-C (51.6%), high LDL-C + hypertension (63.4%), high LDL-C + low HDL-C (45.7%), hypertension + low HDL-C (37.3%), low HDL-C + high LDL-C + hypertension (36.2%), diabetes (34%), high LDL-C + dysglycemia (33.0%). Guideline targets for prediabetes, diabetes, dyslipidemia and hypertension were often not being achieved despite treatment. CMRFs are more common in overweight/obese people with abdominal obesity in primary care, and require more intensive surveillance and management to reduce their cardiometabolic risk.
119 Cardiometabolic Risk Factors in Canadian Primary Care Patients with Abdominal Obesity and Diabetes DAVID C.W. LAU*y, LAWRENCE A. LEITERy, JACQUES J.G. GENEST JR.y, STEWART B. HARRISy, PETER SELBYy, VALERIE TAYLORy, MAJA BUJASBOBANOVICy, JOHN STEWARTy Calgary, AB; Toronto, ON; Montreal, QC; London, ON; Paris, France; Laval, QC This cross-sectional study evaluated the prevalence and the management of cardiometabolic risk factors (CMRFs) in overweight/obese subjects, who were recruited by 468 primary care physicians across Canada. In addition to BMI >27 kg/m2 or high waist circumference, the following risk factors were also assessed: hypertension, dysglycemia (IGT or diabetes by CDA criteria), low HDL-C, triglycerides >1.7 mmol/L, LDL-C >3.5 mmol/L or >2 with cardiovascular event and smoking status. Of a total of 9985 subjects analyzed, 3398 (34%) had diabetes, with a higher mean age than nondiabetic subjects (60.5 years vs. 56.5 years). 77% of people with diabetes were taking oral agents and 18% were treated with insulin, with a mean A1C of 7.13%. More CMRFs were reported in the diabetes subjects, with an average of 4.6 vs. 2.6. People with diabetes were 10-fold more likely to have 5 additional CMRFs (59.6% vs. 5.6%, respectively), and fewer of them had 2 additional CMRFs (3.1% vs. 44.3%). Hypertriglyceridemia and hypertension were more common in the diabetes group (90% vs. 59% and 81% vs. 54% in nondiabetic subjects, respectively). Coronary artery disease, peripheral artery disease and severe renal impairment were more
S45
common in people with diabetes. A greater proportion of them were taking statins for dyslipidemia (76% vs. 35%) and antihypertensive drugs (78% vs. 50%) even though many were not treated to guidelines target values. In conclusion, CMRFs are much more common in overweight/obese people with diabetes in primary care, and require more intensive management to reduce their cardiovascular disease risk and mortality.
120 Glycemic Efficacy of Canagliflozin (CANA) by Baseline A1C and Known Duration of Type 2 Diabetes Mellitus (T2DM) LAWRENCE A. LEITER, LAWRENCE BLONDE, JOHN WILDING, SONIA CERDAS, CINDY TONG, JACQUELINE YEE, GARY MEININGER Toronto, ON; New Orleans, LA; Liverpool, United Kingdom; San José, Costa Rica; Raritan, NJ Purpose: This analysis evaluated the effects of CANA versus placebo (PBO) on changes in A1C based on baseline A1C and duration of T2DM. Methods: Pooled data from 4 PBO-controlled phase 3 studies of patients with T2DM (n¼2313; mean age, 56.0 years; A1C, 8.0%; BMI, 32.1 kg/m2; mean known T2DM duration, 7.3 years) were analyzed. Change in A1C at 26 weeks (last observation carried forward [LOCF]) was evaluated in subgroups by baseline A1C and T2DM duration. Least squares(LS) mean changes (standard error [SE]) were calculated and PBO-subtracted differences (95% confidence interval [CI]) are reported. Results: CANA 100 and 300 mg were associated with progressively greater PBO-subtracted LS mean reductions in A1C as baseline A1C increased (A1C <8.0%: e0.45% and e0.65%; A1C 8.0%e<9.0%: e0.91% and e1.07%; A1C 9.0%: e1.25% and e1.48% respectively). PBO-subtracted A1C reductions with CANA 100 and 300 mg were e0.70% and e0.96%, respectively, for patients in early stages of T2DM (<5 years). In patients with 5e<10 y T2DM duration, PBO-subtracted A1C differences were e0.74 and e0.91% with CANA 100 and 300 mg, respectively; differences were e0.74% and e0.85%, respectively, in patients with 10 years T2DM duration. Overall, CANA doses were generally well tolerated. Summary: Greater reductions in A1C with CANA were seen in patients with higher baseline A1C, similar to what has been observed with other antihyperglycemic agents.
121 Efficacy of Canagliflozin (CANA) in Patients with Type 2 Diabetes Mellitus (T2DM) by Baseline Body Mass Index (BMI) LAWRENCE A. LEITER*, LAWRENCE BLONDE, JOHN WILDING, SONIA CERDAS, CINDY TONGy, JACQUELINE YEEy, GARY MEININGERy Toronto, ON; New Orleans, LA; Liverpool, UK; San Agustín, Costa Rica; Raritan, NJ Purpose: This analysis evaluated the effect of CANA versus placebo (PBO) on changes in A1C, body weight and SBP, stratified by baseline BMI. Methods: Pooled data from 4 PBO-controlled phase 3 studies evaluated changes in A1C, body weight and SBP at 26 weeks (last observation carried forward [LOCF]) by subgroups by baseline BMI (<25 kg/m2, 25 to <30 kg/m2, 30 to <35 kg/m2, and 35 kg/m2 ). Least squares (LS) mean changes were calculated within each subgroup, and PBO-subtracted differences in LS mean changes (95% confidence interval [CI]) are reported. Results: At week 26 (LOCF), LS mean reductions from baseline in A1C levels, body weight and SBP were greater with CANA versus PBO regardless of baseline BMI, with CANA 300 mg generally providing greater reductions in all 3 parameters than CANA 100 mg
8% fitting DM diagnosis. A total of 64% had a diagnosis of established DM or potentially newly diagnosed DM or prediabetes.
118 A Cross-Sectional Survey of Cardiometabolic Risk Factors in Canadian Primary Care Patients with Abdominal Obesity DAVID C.W. LAU*y, LAWRENCE A. LEITERy, JACQUES J.G. GENEST JR.y, STEWART B. HARRISy, PETER SELBYy, VALERIE TAYLORy, MAJA BUJASBOBANOVICy, JOHN STEWARTy Calgary, AB; Toronto, ON; Montreal, QC; London, ON; Paris, France; Laval, QC The objectives of this cross-sectional study were to evaluate the prevalence as well as the management of cardiometabolic risk factors (CMRFs) in overweight/obese Canadians. Subjects with increased body mass index (BMI >27 kg/m2 )/waist circumference (WC >94 cm in men, >80 cm in women) were recruited by 468 primary care physicians across Canada (37% from Ontario, 28% from Quebec and 35% from other provinces), and evaluated during a single clinic visit. In addition, the following risk factors were also assessed: hypertension (SBP >130 and/or DBP >80), dysglycemia (IGT or diabetes), low HDL-C (<1 in men or <1.3 mmol/L in women), triglycerides >1.7 mmol/L, LDL-C >3.5 mmol/L or >2 with cardiovascular event, and smoking status. A total of 9985 subjects were included in the analysis: mean age 58 years, M/F (52%/48%), mean BMI 33.2 and 34.0 kg/m2, mean WC 113.2 cm and 106.4 cm, for men and women, respectively. Women had a median of 3 CMRFs while men had a median of 4 CMRFs. 70% of the subjects had additional CMRFs with the following prevalence: high LDL-C (81.9%), hypertriglyceridemia (69.8%), hypertension (67.2%), low HDL-C (51.6%), high LDL-C + hypertension (63.4%), high LDL-C + low HDL-C (45.7%), hypertension + low HDL-C (37.3%), low HDL-C + high LDL-C + hypertension (36.2%), diabetes (34%), high LDL-C + dysglycemia (33.0%). Guideline targets for prediabetes, diabetes, dyslipidemia and hypertension were often not being achieved despite treatment. CMRFs are more common in overweight/obese people with abdominal obesity in primary care, and require more intensive surveillance and management to reduce their cardiometabolic risk.
119 Cardiometabolic Risk Factors in Canadian Primary Care Patients with Abdominal Obesity and Diabetes DAVID C.W. LAU*y, LAWRENCE A. LEITERy, JACQUES J.G. GENEST JR.y, STEWART B. HARRISy, PETER SELBYy, VALERIE TAYLORy, MAJA BUJASBOBANOVICy, JOHN STEWARTy Calgary, AB; Toronto, ON; Montreal, QC; London, ON; Paris, France; Laval, QC This cross-sectional study evaluated the prevalence and the management of cardiometabolic risk factors (CMRFs) in overweight/obese subjects, who were recruited by 468 primary care physicians across Canada. In addition to BMI >27 kg/m2 or high waist circumference, the following risk factors were also assessed: hypertension, dysglycemia (IGT or diabetes by CDA criteria), low HDL-C, triglycerides >1.7 mmol/L, LDL-C >3.5 mmol/L or >2 with cardiovascular event and smoking status. Of a total of 9985 subjects analyzed, 3398 (34%) had diabetes, with a higher mean age than nondiabetic subjects (60.5 years vs. 56.5 years). 77% of people with diabetes were taking oral agents and 18% were treated with insulin, with a mean A1C of 7.13%. More CMRFs were reported in the diabetes subjects, with an average of 4.6 vs. 2.6. People with diabetes were 10-fold more likely to have 5 additional CMRFs (59.6% vs. 5.6%, respectively), and fewer of them had 2 additional CMRFs (3.1% vs. 44.3%). Hypertriglyceridemia and hypertension were more common in the diabetes group (90% vs. 59% and 81% vs. 54% in nondiabetic subjects, respectively). Coronary artery disease, peripheral artery disease and severe renal impairment were more
S45
common in people with diabetes. A greater proportion of them were taking statins for dyslipidemia (76% vs. 35%) and antihypertensive drugs (78% vs. 50%) even though many were not treated to guidelines target values. In conclusion, CMRFs are much more common in overweight/obese people with diabetes in primary care, and require more intensive management to reduce their cardiovascular disease risk and mortality.
120 Glycemic Efficacy of Canagliflozin (CANA) by Baseline A1C and Known Duration of Type 2 Diabetes Mellitus (T2DM) LAWRENCE A. LEITER, LAWRENCE BLONDE, JOHN WILDING, SONIA CERDAS, CINDY TONG, JACQUELINE YEE, GARY MEININGER Toronto, ON; New Orleans, LA; Liverpool, United Kingdom; San José, Costa Rica; Raritan, NJ Purpose: This analysis evaluated the effects of CANA versus placebo (PBO) on changes in A1C based on baseline A1C and duration of T2DM. Methods: Pooled data from 4 PBO-controlled phase 3 studies of patients with T2DM (n¼2313; mean age, 56.0 years; A1C, 8.0%; BMI, 32.1 kg/m2; mean known T2DM duration, 7.3 years) were analyzed. Change in A1C at 26 weeks (last observation carried forward [LOCF]) was evaluated in subgroups by baseline A1C and T2DM duration. Least squares(LS) mean changes (standard error [SE]) were calculated and PBO-subtracted differences (95% confidence interval [CI]) are reported. Results: CANA 100 and 300 mg were associated with progressively greater PBO-subtracted LS mean reductions in A1C as baseline A1C increased (A1C <8.0%: e0.45% and e0.65%; A1C 8.0%e<9.0%: e0.91% and e1.07%; A1C 9.0%: e1.25% and e1.48% respectively). PBO-subtracted A1C reductions with CANA 100 and 300 mg were e0.70% and e0.96%, respectively, for patients in early stages of T2DM (<5 years). In patients with 5e<10 y T2DM duration, PBO-subtracted A1C differences were e0.74 and e0.91% with CANA 100 and 300 mg, respectively; differences were e0.74% and e0.85%, respectively, in patients with 10 years T2DM duration. Overall, CANA doses were generally well tolerated. Summary: Greater reductions in A1C with CANA were seen in patients with higher baseline A1C, similar to what has been observed with other antihyperglycemic agents.
121 Efficacy of Canagliflozin (CANA) in Patients with Type 2 Diabetes Mellitus (T2DM) by Baseline Body Mass Index (BMI) LAWRENCE A. LEITER*, LAWRENCE BLONDE, JOHN WILDING, SONIA CERDAS, CINDY TONGy, JACQUELINE YEEy, GARY MEININGERy Toronto, ON; New Orleans, LA; Liverpool, UK; San Agustín, Costa Rica; Raritan, NJ Purpose: This analysis evaluated the effect of CANA versus placebo (PBO) on changes in A1C, body weight and SBP, stratified by baseline BMI. Methods: Pooled data from 4 PBO-controlled phase 3 studies evaluated changes in A1C, body weight and SBP at 26 weeks (last observation carried forward [LOCF]) by subgroups by baseline BMI (<25 kg/m2, 25 to <30 kg/m2, 30 to <35 kg/m2, and 35 kg/m2 ). Least squares (LS) mean changes were calculated within each subgroup, and PBO-subtracted differences in LS mean changes (95% confidence interval [CI]) are reported. Results: At week 26 (LOCF), LS mean reductions from baseline in A1C levels, body weight and SBP were greater with CANA versus PBO regardless of baseline BMI, with CANA 300 mg generally providing greater reductions in all 3 parameters than CANA 100 mg