Metabolic effects of dapagliflozin combined with short-term intensive insulin therapy in patients with newly-diagnosed type 2 diabetes mellitus

doi:10.3877/cma.j.issn.2095-9605.2022.01.004

Abstract

Abstract:

Objective

To explore metabolic effects of dapagliflozin combined with short-term intensive insulin therapy in patients with newly-diagnosed T2DM.

Methods

Sixty participants were recruited and randomized to the trial group (receive intensive insulin therapy and dapagliflozin) or the control group (intensive insulin therapy). Data was collected at baseline (d0), 14 days after reaching euglycemia (D14) and at the 12-week visit (W12).

Results

Weight, BMI and waist circumference decreased at W12 in both groups, and the change was more significant in the trial group. In the trial group, serum UA decreased at D14 but significantly elevated at W12, while no change was observed in the control group. TG, TC and LDL-C were decreased in both groups. For HDL-C, the trial group witnessed a significant elevation while no obvious change in the control group.

Conclusions

Dapagliflozin combined with short-term intensive insulin therapy was effective in weight, BMI and waist circumference control, and further improving metabolic indices such as HDL-C.

Key words: Dapagliflozin, Type 2 diabetes mellitus, Insulin, Metabolism

Min Lin. Metabolic effects of dapagliflozin combined with short-term intensive insulin therapy in patients with newly-diagnosed type 2 diabetes mellitus[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2022, 08(01): 24-29.

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References 27

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指标	对照组（n= 30）	试验组（n= 30）	P值
性别（男/女）	24（80.0）/6（20.0）	24（80.0）/6（20.0）	1.000
年龄（岁）	39.3±7.9	41.9±9.1	0.231
收缩压（mmHg）	121±16	120±17	0.841
舒张压（mmHg）	84±13	80±13	0.191
体重（kg）	67.3±10.0	71.0±10.1	0.162
BMI（kg/m²）	24.19±3.47	24.83±2.61	0.423
腰围（cm）	88.6±10.1	90.9±6.5	0.302
HbA1c（%）	11.9±2.2	11.6±2.0	0.637
FPG（mmol/L）	13.25±3.69	14.92±4.53	0.124
白细胞（×10⁹/L）	6.42（2.50）	7.22（2.67）	0.128
血红蛋白（g/L）	151.2±16.8	153.0±19.3	0.702
血小板（×10⁹/L）	237±52	233±62	0.796
ALT（U/L）	18.5（29.0）	20.5（24.0）	0.756
AST（U/L）	15.5（16.0）	17.0（11.0）	0.739
Cr（μmol/L）	70.6±14.2	74.3±14.7	0.320
BUN（mmol/L）	4.26±1.09	4.78±1.49	0.124
UA（μmol/L）	339±62	342±97	0.908
TC（mmol/L）	5.27±1.02	5.30±1.38	0.927
TG（mmol/L）	1.69（1.36）	2.27（1.81）	0.015
HDL-C（mmol/L）	0.98±0.22	0.98±0.25	0.960
LDL-C（mmol/L）	3.68±0.98	3.30±0.96	0.139

指标	对照组（n= 30）	试验组（n= 30）	P值
性别（男/女）	24（80.0）/6（20.0）	24（80.0）/6（20.0）	1.000
年龄（岁）	39.3±7.9	41.9±9.1	0.231
收缩压（mmHg）	121±16	120±17	0.841
舒张压（mmHg）	84±13	80±13	0.191
体重（kg）	67.3±10.0	71.0±10.1	0.162
BMI（kg/m²）	24.19±3.47	24.83±2.61	0.423
腰围（cm）	88.6±10.1	90.9±6.5	0.302
HbA1c（%）	11.9±2.2	11.6±2.0	0.637
FPG（mmol/L）	13.25±3.69	14.92±4.53	0.124
白细胞（×10⁹/L）	6.42（2.50）	7.22（2.67）	0.128
血红蛋白（g/L）	151.2±16.8	153.0±19.3	0.702
血小板（×10⁹/L）	237±52	233±62	0.796
ALT（U/L）	18.5（29.0）	20.5（24.0）	0.756
AST（U/L）	15.5（16.0）	17.0（11.0）	0.739
Cr（μmol/L）	70.6±14.2	74.3±14.7	0.320
BUN（mmol/L）	4.26±1.09	4.78±1.49	0.124
UA（μmol/L）	339±62	342±97	0.908
TC（mmol/L）	5.27±1.02	5.30±1.38	0.927
TG（mmol/L）	1.69（1.36）	2.27（1.81）	0.015
HDL-C（mmol/L）	0.98±0.22	0.98±0.25	0.960
LDL-C（mmol/L）	3.68±0.98	3.30±0.96	0.139

指标	对照组（n=29）			试验组（n=28）
指标	d0	D14	W12	d0	D14	W12
HbA1c（%）	11.9±2.3	9.9±1.4^***	6.4±0.6^{*** $$$}	11.6±2.0	9.6±1.4^***	6.4±0.8^{*** $$$}
FPG（mmol/L）	13.1±3.7	6.2±1.4^***	6.4±1.1^***	15.0±4.7	6.1±1.2^***	6.2±1.0^***
体重（kg）	67.2±10.2	67.5±10.1	66.6±9.8^{* $$$}	71.1±10.4	71.4±10.2	69.9±9.4^{** $$$}
BMI（kg/m²）	24.15±3.53	24.23±3.46	23.92±3.36^{* $$$}	25.02±2.59	25.12±2.57	24.59±2.23^{** $$$}
腰围（cm）	88.7±10.2	87.9±9.7^*	86.7±9.4^{** $}	91.0±6.8	90.4±6.8^*	88.7±6.3^{*** $$$}
Cr（μmol/L）	70.4±14.4	70.0±12.6	71.0±13.9	74.7±15.1	73.3±14.4	74.4±15.0
BUN（mmol/L）	4.24±1.11	4.24±1.19	4.43±1.27	4.84±1.52	4.67±1.34	4.77±1.45
UA（μmol/L）	339±63	344±67	365±107	342±93	304±80^{# **}	349±87^$$$
ALT（U/L）	19.0（29.0）	23.0（21.0）	22.0（29.0）	21.0（24.0）	22.0（16.0）	25.0（24.0）
AST（U/L）	16.0（17.0）	18.0（13.0）	20.0（13.0）	17.0（12.0）	19.0（11.0）	20.0（8.0）
TG（mmol/L）	1.61（1.30）	1.53（0.79）	1.71（1.24）	2.20（1.51）^#	1.57（0.72）^***	1.69（0.79）^***
TC（mmol/L）	5.23±1.01	3.84±0.98^***	4.25±0.86^***	5.29±1.41	3.73±0.66^***	4.19±0.90^{*** $$}
LDL-C（mmol/L）	3.65±0.99	2.45±0.83^***	2.74±0.80^***	3.27±0.98	2.32±0.61^***	2.67±0.73^{* $}
HDL-C（mmol/L）	0.98±0.22	0.97±0.20	1.02±0.21	0.99±0.25	1.01±0.21	1.06±0.21^**

指标	对照组（n=29）			试验组（n=28）
指标	d0	D14	W12	d0	D14	W12
HbA1c（%）	11.9±2.3	9.9±1.4^***	6.4±0.6^{*** $$$}	11.6±2.0	9.6±1.4^***	6.4±0.8^{*** $$$}
FPG（mmol/L）	13.1±3.7	6.2±1.4^***	6.4±1.1^***	15.0±4.7	6.1±1.2^***	6.2±1.0^***
体重（kg）	67.2±10.2	67.5±10.1	66.6±9.8^{* $$$}	71.1±10.4	71.4±10.2	69.9±9.4^{** $$$}
BMI（kg/m²）	24.15±3.53	24.23±3.46	23.92±3.36^{* $$$}	25.02±2.59	25.12±2.57	24.59±2.23^{** $$$}
腰围（cm）	88.7±10.2	87.9±9.7^*	86.7±9.4^{** $}	91.0±6.8	90.4±6.8^*	88.7±6.3^{*** $$$}
Cr（μmol/L）	70.4±14.4	70.0±12.6	71.0±13.9	74.7±15.1	73.3±14.4	74.4±15.0
BUN（mmol/L）	4.24±1.11	4.24±1.19	4.43±1.27	4.84±1.52	4.67±1.34	4.77±1.45
UA（μmol/L）	339±63	344±67	365±107	342±93	304±80^{# **}	349±87^$$$
ALT（U/L）	19.0（29.0）	23.0（21.0）	22.0（29.0）	21.0（24.0）	22.0（16.0）	25.0（24.0）
AST（U/L）	16.0（17.0）	18.0（13.0）	20.0（13.0）	17.0（12.0）	19.0（11.0）	20.0（8.0）
TG（mmol/L）	1.61（1.30）	1.53（0.79）	1.71（1.24）	2.20（1.51）^#	1.57（0.72）^***	1.69（0.79）^***
TC（mmol/L）	5.23±1.01	3.84±0.98^***	4.25±0.86^***	5.29±1.41	3.73±0.66^***	4.19±0.90^{*** $$}
LDL-C（mmol/L）	3.65±0.99	2.45±0.83^***	2.74±0.80^***	3.27±0.98	2.32±0.61^***	2.67±0.73^{* $}
HDL-C（mmol/L）	0.98±0.22	0.97±0.20	1.02±0.21	0.99±0.25	1.01±0.21	1.06±0.21^**

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