Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

Approximately 15% of people living in Canada have type 2 diabetes mellitus ('diabetes'). Patients with diabetes have abnormally high levels of glucose in their blood. Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a new class of oral medications that lower blood glucose by facilitating excretion of glucose into the urine. While clinical trials have demonstrated that these drugs work effectively, there is limited information about their safety since the clinical trials had relatively few patients and were fairly short in duration. I plan to study the safety of these drugs using a variety of study design methods. One such method is through conducting a systematic review and meta-analysis. Specifically, I'll review the existing literature about these medications and summarize, both qualitatively and quantitatively, their overall safety. The other study design will involve "real-world" data. Real-world data are drawn from health care use outside of the traditional clinical trial experimental setting. These data can come from electronic medical records, insurance claims, and registry studies. The benefit of real-world data is that it reflects real-world use and generally contains a lot of participants (i.e., thousands to millions) which allows the detection of rare side-effects. Since SGLT2 inhibitors can lower bone density and affect calcium and vitamin D levels, I want to study whether they increase a patient's risk of breaking a bone. Assessing the risk of fracture for these medications is important, since patients with diabetes are prone to fractures. I will analyze the risk of fractures for patients who newly started SGLT2 inhibitors compared to patients who newly started another type of medication for diabetes. Our study will include over 200,000 participants from three databases (two US databases and one Canadian database) and has the potential to provide timely and highly-relevant information for both patients and their prescriber.