Comparing The Safety And Efficacy Of Sitagliptin Vs Dapagliflozin And The Risk Of Hyperkalaemia Among People With Type 2 Diabetes Mellitus And Kidney Disease

Abstract

Background: Type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) are frequently coexisting conditions associated with high morbidity and mortality. Hyperlalaemia is a major electrolyte disturbance in this population, and drug choice may influence its severity. This study compares the safety and efficacy of Sitagliptin (an DPP-4 inhibitor) and Dapagliflozin (an SGLT2 inhibitor) in T2DM patients with CKD, with particular focus on glycaemic outcomes and hyperkalaemia risk.

Methods: A prospective, observational cohert study was conducted for six months among 152 adults (aged 40-80yrs) with T2DM and CKD. Participants were grouped based on therapy with Sitagliptin or Dapagliflozin. Glycaemic indices (FBS, PPBS, HbA1c, RBS) and serum potassium levels were recorded at baseline and post treatment. Data were analyzed using paired and independent t-tests and Chi-square tests.

Results: Both Sitagliptin and Dapagliflozin achieved significant reductions in HbA1c (8.86 → 7.67% , p<0.001) and PPBS (205.78 →147.57 mg/dl, p<0.001). Dapagliflozin demonstrated a slightly greater decline in PPBS (p=0.035) and serum potassium (5.33 →5.16 mmol/L, p=0.044). The incidence of moderate hyperkalaemia was significantly lower in the Dapagliflozin group (p=0.032).

Conclusion: Dapagliflozin showed superior overall efficacy in improving glycaemic parameters and reducing hyperkalaemia risk, while Sitagliptin remained a safe alternative, especially inn patients with mild renal impairment.