BACKGROUND: Metformin in addition to lifestyle change is the first line therapy for type 2 diabetes mellitus. In time, adequate glucose control can only be achieved with addition of other hypoglycemic drugs. There is emergence of new hypoglycemic drugs like dapagliflozin, an SGLT2 inhibitor, to digress from the usual potential adverse effects of hypoglycemic drugs.
OBJECTIVE: To determine the efficacy of Dapagliflozin as add on in therapy to hypoglycemic drugs in inadequately controlled T2DM patients.
DATA SOURCES: Electronic searches through PUBMED, COCHRANE and Manual Search. Search terms include: dapagliflozin, metformin, insulin, thiazolidinedione, SGLT2, HbA1c, weight loss.
STUDY SELECTION: Randomized, double-blinded, placebo-controlled with good quality were included. Intervention included administration of dapagliflozin as add on to a hypoglycemic drug.
ANALYSIS: Statistical analysis was done using the Review Manager 5.3
RESULTS: 3 RCTs were included in the meta-analysis. The overall effect size of HbA1c calculated from mean difference was -0.54 (z=8.01, p<0.00001) with 95% CI (- 0.67 to -0.41). The effect size of change in body weight was -2.93 (z=10.49, p<0.00001) with 95% CI (-3.48 to -2.38). There is no relation with the occurrence of UTI with dapagliflozin treatment OR=1.20 [95% CI (0.73 to 1.98), p=0.47).
CONCLUSION: The meta-analysis showed that dapagliflozin as add on therapy has improved glycemic control in T2DM with modest weight reduction.