Efficacy of dapagliflozin combined with glucagon-like peptide-1 receptor agonists for patients with type 2 diabetes mellitus

Objective To investigate the effects of dapagliflozin combined with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on hemorheology and insulin resistance in patients with type 2 diabetes mellitus.

Methods A total of 102 patients with type 2 diabetes mellitus in Quanzhou City Hospital of Traditional Chinese Medicine from November 2020 to October 2022 were randomly divided into two groups, with 51 cases in each group. Control group was treated with dapagliflozin, while study group received a combination therapy of dapagliflozin and GLP-1 RAs (liraglutide). The clinical efficacy, blood glucose indicatorsfasting blood glucose (FBG), 2-hour postprandial glucose (2 hPG), glycated hemoglobin (HbA1c), fasting insulin (FINS) and insulin resistancehomeostasis model assessment of insulin resistance (HOMA-IR), homeostasis model assessment of β-cell function (HOMA-β), lipid indicatorstotal cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-densitylipoprotein cholesterol (LDL-C), hemorheological indicatorserythrocyte aggregation index (EAI), hematocrit (HCT), erythrocyte deformation index (EDI), plasma viscosity (PV), and adverse reactions were compared between the two groups.

Results The total effective rate was 94.12% in the study group, which was significantly higher than 80.39% in the control group (P<0.05). After treatment, FBG, 2 hPG, HbA1c and BMI were significantly lower than those before treatment in both groups, and levels of FBG, 2 hPG and HbA1c in the study group were significantly lower than those in the control group (P<0.05). After treatment, FINS and HOMA-β in the study group were significantly higher than those in the control group, while HOMA-IR was significantly lower than that in the control group (P<0.05). After treatment, HDL-C level was significantly higher than that before treatment in both groups, while TC, TG and LDL-C levels were significantly lower in both groups; additionally, HDL-C level after treatment in the study group was significantly higher than that in the control group, while TC, TG and LDL-C levels were significantly lower than those in the control group (P<0.05). After treatment, EAI, HCT, EDI and PV levels were significantly lower than those before treatment in both groups, and levels of indexes mentioned above in the study group were significantly lower than those in the control group (P<0.05). The total incidence of adverse reactions in the study group was 11.76%, which showed no significant difference when compared to 9.80% in the control group (P>0.05).

Conclusion The combination therapy of dapagliflozin and GLP-1 RAs (liraglutide) is effective in the treatment of patients with type 2 diabetes mellitus, which can effectively regulate blood glucose and lipid levels, alleviate insulin resistance, and improve hemorheological indicators.