The efficacy and safety of dapagliflozin in patients with type 2 diabetes receiving insulin therapy

Abstract

Objective To evaluate the efficacy and safety of adding dapagliflozin to insulin therapy in type 2 diabetic patients. Methods A total of 45 hospitalized patients who were uncontrolled by high dose of insulin in the Department of Endocrinology, the Second Hospital of Tianjin City between August and December in 2017 were assigned to combined group (n=23) and insulin group (n=22) according to random number table. Patients in combined group began 10 mg dapagliflozin treatment on the basis of their original oral antidiabetic agents but decreased their original daily insulin dosage by 50%. Patients in insulin group maintained their stable dose of oral antidiabetic agents but adjusted their insulin therapy by frequency and dosage according to the condition and blood glucose level. HbA1c, fasting plasma glucose (FPG), postprandial glucose (PPG), body weight, 24-h urine volume, 24-h urinary microalbumin, blood pressure and blood low density lipoprotein-cholesterol(LDL-C) after 12 weeks were analyzed, and adverse events including hypoglycemia and urinary infection were recorded. Results The FPG, PPG and HbA1c levels were significantly decreased from baseline in combined group and insulin group (t′=6.448-11.360, all P 0.05). There was fewer hypoglycemia events in combined group than that in insulin group (χ2=5.847, P 0.05). One patient in combined group experienced urinary tract infection, while there was no statistic difference in the incidence of urinary tract infection between the two groups (P>0.05). Conclusion In patients with uncontrolled type 2 diabetes by high dose insulin, dapagliflozin is superior in glycemic control than insulin treatment without increasing the risk of hypoglycemia. Key words: Type 2 diabetes mellitus; Dapagliflozin; Sodium-glucose cotransporter 2 inhibitor