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IJOPP · Lens · Long-Term Comparative Effects of SGLT-2 and DPP-4 Inhibitors on Lipid Profiles and Cardiometabolic Outcomes in Type 2 Diabetes: Real-World Evidence

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Article · Volume 19, Issue 2 · pp. 272–280

Long-Term Comparative Effects of SGLT-2 and DPP-4 Inhibitors on Lipid Profiles and Cardiometabolic Outcomes in Type 2 Diabetes: Real-World Evidence

Syed Afzal Uddin Biyabani1, Neelkantreddy Patil1, Hafsa Naema1, Safa Wasay2, Syed Raziuddin Faisal3

  1. 1Department of Pharmacy Practice, Matoshree Taradevi Rampure Institute of Pharmaceutical Sciences, Kalaburagi, Karnataka, INDIA.
  2. 2Department of Pharmacy Practice Jawaharlal Nehru Technological University Telangana, Hyderabad, Telangana, INDIA.
  3. 3Department of Pharmacy Practice, Visveswarapura Institute of Pharmaceutical Sciences, 24th Main, Banashankari 2nd Stage Bengaluru, Karnataka, INDIA.

Abstract

Background: Dyslipidaemia represents a major contributor to cardiovascular morbidity in patients with Type 2 Diabetes Mellitus (T2DM). Sodium-glucose cotransporter-2 (SGLT-2) inhibitors and Dipeptidyl Peptidase-4 (DPP-4) inhibitors are commonly prescribed antihyperglycemic agents; however, their comparative long-term effects on lipid and cardiometabolic parameters in real-world settings remain insufficiently explored.Objectives: This 12-month observational study compared the longitudinal effects of SGLT-2 and DPP-4 inhibitors on lipid profiles-total cholesterol, triglycerides, LDL-C, HDL-C, and VLDL-C-and assessed potential cardiometabolic benefits beyond glycaemic control.Materials and Methods: A prospective, real-world observational study was conducted at a tertiary care hospital over 12 months. A total of 252 patients with T2DM were enrolled; after excluding 52 patients lost to follow-up, 200 participants completed the study. Patients were divided equally into two groups: Group A (SGLT-2 inhibitors) and Group B (DPP-4 inhibitors). Lipid and cardiometabolic parameters were measured at baseline, 3, 6, 9, and 12 months. Statistical analyses were performed using SPSS version 31.0, employing paired t-tests, repeated measures ANOVA, and post hoc Bonferroni and Sidak tests, with p<0.05 considered significant.Results: Compared to DPP-4 inhibitors, SGLT-2 inhibitors produced greater reductions in total cholesterol (-20 mg/dL), triglycerides (-19.95 mg/ dL), LDL-C (-20.98 mg/dL), and VLDL-C (-8.04 mg/dL), along with a more pronounced increase in HDL-C (+8.02 mg/dL vs. +2.00 mg/dL). These changes, alongside modest improvements in anthropometric indices, suggest favourable cardiometabolic effects and a potential reduction in cardiovascular risk.Conclusion: SGLT-2 inhibitors demonstrated superior lipid-modifying and cardiometabolic benefits compared with DPP-4 inhibitors, reinforcing their dual role in improving both metabolic control and cardiovascular risk profiles in patients with type 2 diabetes. Larger randomized controlled studies are warranted to validate these real-world findings.

Keywords: Cardiometabolic outcomes; DPP-4 inhibitors; Lipid profile; SGLT-2 inhibitors; Type 2 diabetes mellitus

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