Clinical Efficacy Of Dapagliflozin In Early Type 2 Diabetic Nephropathy:An Observational Study

Objective:To observe the clinical efficacy and safety of SGLT2 inhibitor in early renal disease of type 2 diabetes mellitus.Methods:a prospective study was conducted to select 86 hospitalized patients who were admitted to Handan Central Hospital for early diagnosis of type 2 diabetes and early renal disease.2020.06-2021.08:All patients were randomly divided into two groups.The control group was treated with metformin combined with insulin(glargine+aspart),and the experimental group was treated with dapagliflozin on the basis of the control group.The two groups were given diabetes education and education.Combined with the monitoring of blood glucose and actual situation,the dosage of metformin and insulin was adjusted.The target of blood glucose control was FBG<7 mmol/L,2hPBG<10 mmol/L,and the end point of treatment lasted for 12 weeks.The general data and laboratory indexes(including age,gender,height,weight,BMI,blood pressure,blood glucose,blood lipid,proteinuria,Cys-C and ACR)of the two groups before treatment were collected for baseline comparison.After 12 weeks,the hospital took blood and urine,and rechecked the relevant indexes.The indexes before and after treatment and between the two groups were analyzed and compared,and the adverse events and side effects during treatment were recorded.SPSS 26.0 was used for statistical analysis of data indicators.The measurement data are expressed in X ± S.independent sample t-test is used between the two groups,and paired sample t-test is used for intra group comparison.Count data were expressed in(%),and X2 test was used for comparison between groups.The difference was statistically significant(P<0.05).Results:before treatment,there was no significant difference between the two groups(P>0.05).Compared with before treatment,the blood glucose indexes of the two groups decreased after 12 weeks of treatment(P<0.001),but the glucose control level of the experimental group was lower(P<0.001).After 12 weeks of treatment,BMI,SBP,DBP,TC,TG,ACR,mAlb,NLR and Cys-C in the experimental group were lower than those in the control group in the same period(P<0.05),and HDL-C was higher than that in the control group in the same period(P<0.05).There was no significant change in the levels of EGFR and LDL-C in the two groups(P>0.05).Compared with the adverse events and side effects of the two groups,the incidence of hypoglycemia in the experimental group was lower,but there was a certain rate of urinary tract infection.Conclusion:on the basis of reducing blood glucose in patients with early T2DM nephropathy,dagliejing has independent renal protective effects,such as reducing body mass index,increasing insulin sensitivity,reducing blood pressure,reducing uric acid and reducing urinary protein.