The Randomized Controlled Trial Of Additional Use With Dapagliflozin Or Saxaglipin In T2DM Patients With Poorly Controlled Blood Glucose By Using Metformin Alone

Objective: To investigate the effects of additional use with Dapagliflozin or Saxagliptin in type 2 diabetes mellitus(T2DM)patients with poorly controlled blood glucose by using metformin alone on blood glucose metabolism,lipid metabolism,inflammation reaction.Methods:1.A total of 70 patients with T2 DM who visited our hospital from October 2018 to May 2019 were selected as the study objects.The blood glucose was still poorly controlled after more than 12 weeks of treatment(given metformin of or greater than 1500 / d monotherapy for patients).They were randomly divided into observation group and control group,with 35 cases in each group.Patients in both groups were treated with metformin.The control group was treated with saxagliptin on this basis,the observation group was treated with dapagliflozin.All were continuously treated for 24 weeks.During the treatment,both groups of patients were given exercise guidance and dietary intervention,and at the same time,they were not allowed to drink alcohol in large quantities to avoid hypoglycemia and side effects.2.The changes of blood glucose metabolism,lipid metabolism,inflammation reaction,and blood pressure were compared before and after treatment,the safety of cure,and adverse reactions were observed.Results:1.After treatment,the levels of fasting blood glucose(FPG),postprandial blood glucose(2h PG)and glycosylated hemoglobin(Hb A1c)were significantly lower(P<0.05),the reduction of FPG,2h PG and Hb A1 c levels in the observation group were more than those in the control group(P<0.05);2.After treatment,the levels of total cholesterol(TC)and triglyceride(TG)decreased,and the level of high-density lipoprotein cholesterol(HDL-C)increased,besides the rising or falling was higher in the observation group than that in the control group(P<0.05).There was no significant difference in the level of low-density lipoprotein cholesterol(LDL-C)between the observation group and the pre-treatment group.(P>0.05);3.After treatment,the levels of high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)were significantly reduced in the two groups compared with before treatment(P<0.05),and the levels of hs-CRP and TNF-α in the observation group were lower than those in the control group(P<0.05);4.After treatment,the systolic blood pressure and diastolic blood pressure of the observation group were lower than the control group(P<0.05);5.There were no significant differences in the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen(BUN),Urinary albumin/creatinine ratio(ACR)before and after treatment between the two groups(P>0.05);6.One case of hematuria occured in the observation group.Hematuria disappeared after 2 days of withdrawal.Conclusions:1.Dagliflozin can effectively regulate blood glucose and lipid metabolism in patients with T2 DM,and has a certain antihypertensive effect.2.Dagliflozin can effectively reduce inflammation reaction.3.Dagliflozin has high safety,less adverse reactions.