Add-on dapagliflozin improves outcomes in uncontrolled T2D

Patients with type 2 diabetes (T2D) uncontrolled on current insulin therapy may benefit from adjunctive dapagliflozin, which has been shown to enhance glycaemic control and additionally lead to weight loss, reduction in insulin requirement, and fewer hypoglycaemic events.

The case–control study involved a cohort of patients with glycated haemoglobin (HbA1c) >7 percent despite insulin therapy. Patients assigned to the study group received sodium-glucose cotransporter-2 inhibitor dapagliflozin (10 mg once daily) as an adjunct treatment, whereas those in the control group had their existing insulin dose uptitrated by a mean of 21.6 percent from baseline.

The primary endpoint of HbA1c after 12 months was much greater in the study group (from 8.9 percent at baseline to 8.0 percent) than in the control group (from 9.1 percent to 8.7 percent). The same was true for fasting plasma glucose and postprandial 2-h glucose.

Dapagliflozin produced a marked reduction in systolic blood pressure (−4.7 mm Hg) and body weight (−1.4 kg), whereas the latter increased by 0.6 kg in the control group. The study group also had significantly fewer hypoglycaemic events (18.5 percent vs 32.6 percent, respectively).

Daily insulin dose increased by 21.6 percent in the control group but fell by 4.5 percent in the study group (5.4 vs –1.9 U; p<0.001).

The findings suggest that using dapagliflozin as an adjunct to insulin therapy may improve outcomes for patients with uncontrolled T2D.