What are the indications for dapagliflozin in the treatment of type 2 diabetes mellitus (DM)?

Updated: Oct 23, 2019
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
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Answer

Dapagliflozin is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. [195, 196]  It can be employed as monotherapy, as initial therapy with metformin, or as an add-on to other oral glucose-lowering agents, including metformin, pioglitazone, glimepiride, sitagliptin, and insulin. [202, 203, 204, 205]  

In October 2019, dapagliflozin gained an indication to reduce hospitalization for heart failure in adults with type 2 diabetes and cardiovascular risk. FDA approval was based on the Dapagliflozin Effect on Cardiovascular Events–Thrombolysis in Myocardial Infarction 58 (DECLARE-TIMI 58) study, in which 17,160 patients were evaluated (median 4.2-year follow-up). The investigators found that in patients on dapagliflozin, the rate of cardiovascular death or hospitalization for heart failure was 4.9%, compared with 5.8% for patients on placebo. [206]


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