The Effect Of Dapagliflozin On Blood Glucose Fluctuation In Type 2 Diabetes Patients With Substandard Blood Glucose

Objective To observe the effect of dapagliflozin on blood glucose fluctuation in type2 diabetes patients with substandard blood glucose who use insulin combined with several oral hypoglycemic drugs.Methods 42 type 2 diabetes patients of poor blood glucose control with insulin and two oral hypoglycemic agents of different mechanisms were randomly divided into the observation group and the control group with 21 cases,respectively.The control group was treated with acarbose on the basis of the original treatment,The observation group was treated with dapagliflozin on the basis of the original treatment.Both groups were treated for 24 weeks.Fasting blood glucose(FBG),two-hour postprandial blood glucose(2h PG),glycated hemoglobin(Hb A1c),fasting c-peptide(FC-P),two-hour postprandial c-peptide(2h C-P),uric acid(UA),total cholesterol(TC),triglyceride(TG),body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),daily insulin dosage were detected between the two groups before and after treatment.The mean amplitude of glucose excursions(MAGE),mean blood glucose(MBG),Standard deviation of blood glucose(SDBG)and lage amplitude of glucose excursions(LAGE)were evaluated by continuous glucose monitoring system.To observe the adverse reactions occurred during the treatment.Results There is no difference of baseline datas between two groups(P>0.05).After24 weeks treatment,FBG,2h PG,Hb A1 c,BMI,SBP,DBP and daily insulin dose were decreased in two groups.And these parameters in the observation group was significantly lower than the control group(P<0.05).FC-P and 2h C-P were increased intwo groups,and the observation group FC-P and 2h C-P were dramantically higher than the control group(P<0.05).The UA,TC and TG were significantly decreased in the observation group(P<0.05),while there was no significant change in the control group after treatment(P>0.05).MAGE,MBG,SDBG and LAGE decreased in two groups,and the results in the observation group were significantly lower than those in the control group(P<0.05).Conclusions Dapagliflozin can significantly reduce the blood glucose of patients with type 2 diabetes mellitus who fail to meet the standard in the treatment of insulin combined with a variety of oral hypoglycemic drugs.Beside,it can improve the fluctuation of blood glucose and the function of islet β cells,and do not significantly increase adverse reactions such as hypoglycemia.