Experience of dapagliflozin combined with intensive insulin therapy for type 2 diabetes mellitus patients

Abstract

Objective To investigate the efficacy and safety of dapagliflozin combined with intensive insulin therapy on type 2 diabetes mellitus (T2DM) patients with poor blood glucose control. Methods Eighty T2DM patients with poor blood glucose control admitted to Luohe Central Hospital from January 2018 to March 2019 were selected and randomly divided into control group and observation group, with 40 cases in each group. The control group was given intensive insulin therapy alone, while the observation group was given dapagliflozin orally based on the treatment of the control group. The levels of glycosylated hemoglobin (HbA1c), mean amplitude of glycemic excursions (MAGE) and body mass index (BMI) before and 12 weeks after treatment were compared between the two groups. The daily dosage of insulin, standards-reaching time and hypoglycemic events of the two groups were recorded. Results HbA1c in the observation group was (6.67±1.10)%, lower than the (7.56±0.97)% in the control group. The daily dosage of insulin in the observation group was (27.67±7.13)U, less than the (36.45±5.30)U in the control group. Mean amplitude of plasma glucose (MAGE) in the observation group was (4.20±0.64)mmol/L, lower than (6.10±0.92)mmol/L in the control group. Hypoglycemia events in the observation group were (0.83±0.55) times, less than (1.68±0.86) times in the control group. The BMI in the observation group was (27.69±2.08) kg/m2, which was lower than (28.25±2.21) kg/m2 in the control group.And the differences in the above indexes were statistically significant between the two groups (all P<0.05). Conclusions Dapagliflozin combined with intensive insulin therapy is safe and effective for T2DM patients whose blood glucose is inadequately controlled. It can reduce the daily dose of insulin, shorten the standards-reaching time, reduce hypoglycemia events, and effectively control body mass. It is worthy of clinical promotion. Key words: Type 2 diabetes mellitus; Dapagliflozin; Intensive insulin therapy