Is dapagliflozin safe and effective as combination treatment in patients with type 2 diabetes?

This study examined whether dapagliflozin was safe and effective in combination with metformin and a sulfonylurea.

Patients with type 2 diabetes (T2D) initially produce insulin (hormone which lowers blood glucose [sugar] levels). However, T2D patients are often resistant to insulin, and it does not effectively lower blood glucose. Drugs such as metformin (Glucophage) aim to help insulin work in the body. However, the pancreas eventually reduces or stops insulin production. Metformin is then generally combined with a sulfonylurea drug. This increases the release of insulin from the pancreas. However, the effectiveness of these insulin-secreting drugs decreases over time.

Dapagliflozin (Forxiga) is a drug which reduces the transport of glucose from the kidneys into the blood. Dapagliflozin may be used in combination with metformin and a sulfonylurea. However, it is not known whether this combination is safe and effective.

This study aimed to determine whether dapagliflozin combination treatment is safe and effective in T2D patients.

This study involved 219 T2D patients divided into 2 groups. One group received metformin, a sulfonylurea and a placebo (substance with no therapeutic effect). The other group received metformin, a sulfonylurea and 10 mg of dapagliflozin. Patients received this treatment for 52 weeks.

HbA1c (average blood glucose levels over three months) levels were lower in patients receiving the dapagliflozin combination (decrease of 0.8%) compared to the group who did not receive the dapagliflozin combination (decrease of 0.1%). 27.3% of patients receiving the dapagliflozin combination achieved an HbA1c of less than 7% compared to 11.3% of patients who did not receive the dapagliflozin combination.

Side effects were similar in both groups. However, more patients treated with the dapagliflozin combination (15.6%) experienced hypoglycemia (dangerously low blood glucose levels) compared to the group who did not receive the dapagliflozin combination (8.3%).

This study concluded that dapagliflozin is safe and effective in combination with metformin and a sulfonylurea.

Some of the authors are employed by AstraZeneca, the company which developed the drug.

Consult your physician regarding the risks and benefits of dapagliflozin combination treatment.