The Impact of Different Oral Antidiabetic Drugs on Insulin Pump Intensive Therapy in Type 2 Diabetes Patients: A Clinical Study.

Abstract

Objective: This study aimed to compare the effects of insulin pump intensive therapy alone with those of insulin pump intensive therapy combined with metformin or dapagliflozin on the time to achieve glycemic targets, total insulin dose at the end of intensive therapy, and pancreatic function. The study aimed to understand the impact of adding the traditional antidiabetic drug metformin and the novel antidiabetic drug dapagliflozin to routine intensive insulin therapy on treatment outcomes.

Methods: A total of 110 patients with newly diagnosed T2DM (with glycated hemoglobin >9%, fasting blood glucose >11.1 mmol/L, or obvious symptoms of hyperglycemia) were enrolled in a single-center randomized controlled trial. Patients were randomized into three groups. The final analysis included 81 participants (73.6% of the enrolled) with complete data for the primary outcomes, distributed as follows: Group 1 (insulin only, n = 25), Group 2 (insulin plus dapagliflozin, n = 20), and Group 3 (insulin plus metformin, n = 36). The term "newly diagnosed" was defined as a diagnosis confirmed within 1 year prior to enrollment, in accordance with the Chinese guidelines for the prevention and treatment of T2DM. All patients were either treatment-naïve or had not received any sustained glucose-lowering pharmacotherapy for more than 2 weeks since diagnosis. The primary outcomes were the time to achieve glycemic targets, total insulin dose at the end of intensive therapy, and pancreatic function.

Results: The fasting insulin levels in all the treatment groups changed over time, with greater decreases observed in the insulin pump therapy alone group and the insulin pump therapy + dapagliflozin group than in the insulin pump therapy + metformin group.

Conclusion: These findings suggest that compared with metformin, dapagliflozin combined with intensive insulin pump therapy holds greater promise for optimizing glycaemic control in patients with T2DM, thus providing a more promising option for clinical practice.