Abstract body	Background
Dapagliflozin, sodium-glucose cotransporter-2 (SGLT-2) inhibitor, reduces hyperglycemia and body weight by inhibiting renal glucose reabsorption. However, only a few studies have shown the efficacy of dapagliflozin in type 2 diabetic patients.
Aim
We evaluated the pedictive factors and efficacy  of weight loss of dapagliflozin in real practice with type 2 diabetes in Korea
Method
This is a retrospective, observational study, data from 61 patients with 12 months of dapagliflozin(10mg once-daily) therapy were analyzed, visited medical center from January 2015 to July 2016. We had divided into three treatment groups: first group was dual combination of dapagliflozin and metformin(Group 1); second group was triple combination of dapagliflozin and metformin with sulfonylurea or dipeptidyl-peptidase IV(DPP-4) inhibitors(Group 2); third group was quadriple combination of dapagliflozin, metformin and sulfonylurea with DPP-4inhibitors(Group 3).
Results
After 12 months, mean change from baseline body weight was -3.4±2.6 kg(P<0.001) for total, -3.4±3.1 kg(P<0.001) for group 1, -2.7±2.0 kg(P=0.008) for group 2,-4.0±2.3 kg(P<0.001) for group 3. Patients who achieved body weight reduction of ≥5% after 12 months were classified in the responder group and<5% non-responder group. There were baseline fasting C-peptide level was higher in responder group than non-responder group(3.25±1.07ng/mL vs. 2.62±1.02 ng/mL, P=0.023). In responder and non-responder groups, serum fasting insulin levels were 13.6±5.9 µIU/mL and 11.4±7.5 µIU/mL (P=0.064) respectively. HOMA-IR ([fasting insulin (µIU/ml) X fasting plasma glucose (mmol/L)]/22.5) levels were 5.4±2.3 and 5.4± 5.8 (P=0.074) respectively. However, they were not significant in statistical analysis. Reduction in body weight was evaluated according to initial BMI and HbA1c. After 12 months of treatment, the degree of body weight reduction was not related with initial BMI and HbA1c level.
Overall reductions in HbA1c and PP2 glucose levels were -0.61±0.82% (P<0.001) and -35.4±62 mg/dL(P<0.001) respectively. There were no serious adverse event including hypoglycemia in dapagliflozin group.
Discussion
In patients with type 2 diabetes, SGLT-2 inhibitor improved glycemic control and reduced body weight reduction with safety of dapagliflozin. Baseline fasting C-peptide level was predictive factor of weight loss on dapagliflozin in type 2 diabetes mellitus.

Predictive factor of weight loss on SGLT-2 inhibitor in people with type 2 diabetes mellitus