Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Nov 15, 2020; 11(11): 540-552
Published online Nov 15, 2020. doi: 10.4239/wjd.v11.i11.540
Glucagon-like-1 receptor agonists and sodium/glucose cotransporter-2 inhibitors combination—are we exploiting their full potential in a real life setting?
Maja Cigrovski Berkovic, Ines Bilic-Curcic, Tomislav Bozek, Davorka Herman Mahecic, Sanja Klobucar Majanovic, Silvija Canecki-Varzic, Jelena Andric, Srecko Marusic, Anna Mrzljak
Maja Cigrovski Berkovic, Ines Bilic-Curcic, Silvija Canecki-Varzic, Faculty of Medicine, J. J. Strossmayer University Osijek, Osijek 31000, Croatia
Maja Cigrovski Berkovic, Jelena Andric, Srecko Marusic, Department for Endocrinology, Diabetes and Clinical Pharmacology, Clinical Hospital Dubrava, Zagreb 10000, Croatia
Maja Cigrovski Berkovic, Department of Kinesiological Anthropology and Methodology, Faculty of Kinesiology, University of Zagreb, Zagreb 10000, Croatia
Ines Bilic-Curcic, Silvija Canecki-Varzic, Department of Endocrinology and Metabolism Disorders, Clinical Hospital Center, Osijek 31000, Croatia
Tomislav Bozek, University Clinic for Diabetes “Vuk Vrhovac”, Merkur University Hospital, Zagreb 10000, Croatia
Tomislav Bozek, Srecko Marusic, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
Davorka Herman Mahecic, Department for Endocrinology, Diabetes and Metabolism, University Hospital Centre “Sestre milosrdnice”, Zagreb 10000, Croatia
Sanja Klobucar Majanovic, Department for Endocrinology, Diabetes and Metabolism, University Hospital Centre Rijeka, School of Medicine, University of Rijeka, 51000 Rijeka, Croatia
Anna Mrzljak, Department of Medicine, Merkur University Hospital, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
Author contributions: Cigrovski Berkovic M and Bilic-Curcic I equally contributed to the design, acquisition of data and interpretation of data and wrote the manuscript; Bozek T, Herman Mahecic D, Klobucar Majanovic S, Canecki-Varzic S, Andric J and Marusic S made contributions to acquisition of data or analysis and interpretation of data; Mrzljak A made contributions to the interpretation of the data and revised the manuscript; All authors read and approved the final version of the manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the University Hospital Centre “Sestre milosrdnice”.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement checklist of items, and the manuscript was prepared and revised according to the STROBE Statement checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Anna Mrzljak, MD, PhD, Reader (Associate Professor), Department of Medicine, Merkur University Hospital, School of Medicine, University of Zagreb, Zajčeva 19, Zagreb 10000, Croatia. anna.mrzljak@mef.hr
Received: August 13, 2020
Peer-review started: August 13, 2020
First decision: September 16, 2020
Revised: September 29, 2020
Accepted: October 19, 2020
Article in press: October 19, 2020
Published online: November 15, 2020
Processing time: 91 Days and 12.8 Hours
Core Tip

Core Tip: Both glucagon-like-1 receptor agonists and sodium/glucose cotransporter-2 inhibitors when added sequentially to the other or simultaneously decrease the hemoglobin A1c (HbA1c) and reduce the body mass index, but the weight loss and glucose-lowering potential is not additive in case of their simultaneous use. Half of the patients achieved target HbA1c below 7%, irrespective of treatment group (sequential or simultaneous addition). Five percent weight loss was dominantly achieved in the simultaneous therapy group. Composite outcome (reduction of HbA1c below 7% with 5% weight loss) was achieved in 32.3%, while 18.2% of total patients attained composite outcome defined as HbA1c below 7% with 5% weight loss and low-density lipoprotein cholesterol < 2.5 mmol/L.