Effectiveness of triple therapy with dapagliflozin add-on to dual therapy over 52 weeks in patients with uncontrolled type 2 diabetes mellitus in a centre of high complexity, Cali-Colombia

Objectives:To evaluate the effectiveness of adding dapagliflozin as an intensification strategy for the treatment of patients with uncontrolled type 2 diabetes mellitus (T2DM). Materials and methods: A historical cohort study was conducted in 123 adult patients over 18 years old who were diagnosed with uncontrolledT2DM, who received dapagliflozin add-on to their dual base treatment: metformin plus glibenclamide (n = 32), metformin plus saxagliptin (n = 29), metformin plus exenatide (n = 28), or metformin plus insulin (n = 34).The endpoints were evaluated using analysis of variance. All the patients completed a 52-week follow-up. Overall, 52.85% of patients were female, the Hispanic population represented the largest proportion of patients in all groups (60.98%), and the mean +/- SD patient age and body weight were 55.05 +/- 7.58 years and 83.55 +/- 9.65 kg, respectively. The mean +/- SD duration ofT2DM, glycated hemoglobin (Hbk(1c)), and fasting plasma glucose (FPG) were 5.93 +/- 2.98 years, 8.1 +/- 0.53%, and 166.03 +/- 26.80 mg/dL, respectively. The grand mean changes of HbA(1c), FPG, body weight and blood pressure showed a decreasing trend during the study period and it was statistically significant in all groups (p-value = <0.001). The proportion of patients achieving HbA(1c) target (<7%) was highest in the group that used a dapagliflozin add-on to metformin plus saxagliptin. Conclusion . The addition of dapagliflozin as an alternative for intensification of dual therapy consistently improved, not only FPG and HbA(1c), but also body weight and blood pressure, with statistically significant results.