Type 2 Diabetes Mellitus Clinical Trial
Official title:
Real-world Data on Dapagliflozin: Characteristics and Health Outcomes of Patients With Type 2 Diabetes Treated With Dapagliflozin in Conjunction With Insulin
Real-world data can supplement the knowledge gained from traditional randomized controlled
trials. To date, only a couple of studies (Andrew et al. 2014 and Wilding et al. 2015) have
been conducted assessing the use of dapagliflozin in the real-world clinical settings in the
United Kingdom and no research has been done on the use of dapagliflozin in Canadian
clinical practice settings.
To the investigators' knowledge, no real-world study exits assessing the impact of using
dapagliflozin in conjunction with insulin in people with type 2 diabetes mellitus on dosage
and frequency of insulin, oral antiglycemic agents and hypertension drugs. This study will
use an electronic medical record-based data that contains demographic, drug coverage,
vitals, lab results, medical problems and diabetes-related complications, and medication
prescription information of patients with diabetes received care from all outpatient
diabetes clinics in London Ontario, Canada to assess the impact of using dapagliflozin in
conjunction with insulin in patients with type 2 diabetes mellitus on health outcomes, and
medications dosing and frequency.
Adult individuals (age≥18) with type 2 diabetes mellitus receiving care at the diabetes
outpatient clinics at St. Joseph's Health Centre London (Canada) who have been treated with
dapagliflozin in conjunction with insulin therapy will be selected from the Web DR
researchable database for this study. Web DR is a diabetes-specific, web-based,
researchable, electronic medical record and database. With no existing electronic medical
record tailored for diabetes patients, the system was designed and implemented by the Centre
for Diabetes, Endocrinology and Metabolism of St. Joseph's Health Care London. The St.
Joseph's Centre for Diabetes, Endocrinology and Metabolism is the primary regional center
for diabetes and endocrine disease management in Southwestern Ontario. Web DR is an
electronic medical record with clinician-friendly pick-lists to enable structured electronic
medical record data collection at the point of care, and is currently being used by 14
Endocrinologists and three Family Physician Diabetologists in the outpatient diabetes
clinics at St. Joseph's Health Care London, Canada.
The baseline period will be 6 months to allow for more complete observation of comorbidities
and medication use patterns. HbA1c, lipid, blood pressure, weight and other clinical
indicators measured during the baseline period (closest to the date of dapagliflozin
prescription) and follow-up period (3 and 6 months after prescription of dapagliflozin) will
be extracted from the database. The last clinical value within the follow-up period and ≥30
days after the start of the medication data will be selected as follow-up information.
The type of insulin used and dosages prescribed during the study follow-up period will be
extracted from the database to examine the insulin dosage prescription pattern and
understand the use of insulin with dapagliflozin and its impact on clinical outcomes.
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