Changes in blood glycemic variations in fragile diabetics treated with intensive insulin therapy combined with dapagliflozin

Twenty inadequately controlled diabetic patients treated with insulin therapy received dapagliflozin treatment for 12 weeks. HbA1C, glycemic variations, plasma 8-iso-prostaglandin F2α (8-PGF2α), and hypersensitive C-reactive protein (hs-CRP) levels, the change of the insulin dose, and the safety of treatments were analyzed. The results showed that after 12-week dapagliflozin therapy, HbA1C, fasting plasma glucose, postprandial 2h plasma glucose, inter-quartile range, standard deviation of blood glucose, large amplitude glycemic excursions, postprandial glucose excursion, as well as absolute means of daily difference were significantly decreased (P<0.01). Compared with those before treatment, addition of dapagliflozin notably decreased plasma 8-PGF2α and hs-CPR levels, along with reduced insulin dosage (P<0.01) and decreased body weight of patients (P<0.05). After dapagliflozin treatment, the hypoglycemia of the patients was obviously improved, without report of severe hypoglycemia. These results indicate that dapagliflozin treatement improves glucose metabolism, and reduces insulin dosage and the hypoglycemic events in fragile diabetics with intensive insulin therapy. (Chin J Endocrinol Metab, 2018, 34: 844-847) Key words: Fragile diabetes; Sodium-glucose transporter 2 inhibitor; Insulin; Treatment