The efficacy and safety of dapagliflozin combined with oral hypoglycemic agents in patients with type 2 diabetes: a systematic review and meta-analysis

Background: There were reports that many patients with type 2 diabetes mellitus (T2DM) could not maintain the normal level of glycemic, who were treated with the antidiabetic agents. The SGLT2 inhibitors could improve patients' blood glucose level by inducing glycosuria, improving insulin sensitivity and the function of beta-cell and decreasing glucose toxicity. Which was unlike with other agents, indicating that the SGLT2 inhibitors might be effective alone or in combination with any other drugs. As a SGLT2 inhibitor, Dapagliflozin could be used in patients with T2DM. Methods: Studies' identification were conducted with the literature search, and we searched studies published between 1950 and 2021 in PubMed, the Cochrane Library and Embase. A meta-analysis was performed using RevMan 5.3 software. Continuous data are presented as the means and standard deviations of differences in performance before and after active or control interventions. Adverse events were also assessed. Results: Fifteen studies that provided individual data were included. Treatment with dapagliflozin was compared with treatment with placebo and resulted in a significantly greater change in HbA1c levels, fasting plasma glucose (FPG) and weight. In terms of the incidence of adverse drug reactions, the incidence of hypoglycemic events was not significantly different between the experimental and control groups. However, the incidences of genital infection and urinary tract infection were higher in the experimental group than in the control group. Discussions: According to the available data, dapagliflozin combined with oral hypoglycemic agents can effectively reduce the level of HbA1c and body weight; however, it does not increase the incidence of hypoglycemia but can cause urinary tract infection and genital infection. Due to the limited literature included, the above conclusions need to be verified through more high-quality studies.