Introduction: Diabetes is a complex chronic disease that requires multiple intervention strategies to reduce the risk of systemic complications manifested in the short and long term. Sodium-glucose co-transporter-2 inhibitors (SGLT2i) are a promising new therapy in the treatment of type 2 diabetes, and due to their mechanism of action these SGLT2i have shown benefit beyond the control of the glycemia.

Objective: To assess the clinical impact of the addition of dapagliflozin in triple therapy in patients with uncontrolled type 2 diabetes.

Design: Quasi-experimental trial conducted from August 2015 to February 2018 in the Endocrinology Unit at Imbanaco Medical Center. Cali, Colombia.

Methods: 89 patients with uncontrolled type 2 diabetes (HbA1c >7%) received open-label dapagliflozin (10mg/day) as an add-on to dual treatment (Group-A (n=32): Metformin 1.700mg/day plus glibenclamida 10mg/day; Group-B (n=29): Metformin 1.700mg/day plus saxagliptin 5mg/day; and Group-C (n=28): Metformin 1.700mg/day plus exenatide 2mg/week subcutaneous). The primary efficacy end point was change in HbA1c, basal glycemia, body weight and blood pressure from baseline to week 52. Comparisons of participant characteristics between these three groups at baseline were performed using ANOVA tests.

Results: see Table.

Conclusion: Triple therapy with the addition of dapagliflozin produced statistically significant improvements in HbA1c, basal glycemia, body weight and blood pressure in patients with type 2 diabetes that were inadequately controlled with dual therapy. The combination metformin plus saxagliptin plus dapagliflozin showed better results.

DAPAGLIFLOZIN USE IN TRIPLE THERAPY FOR TREATING TYPE 2 DIABETES IN THE ENDOCRINOLOGY UNIT AT IMBANACO MEDICAL CENTER. CALI, COLOMBIA