Dapagliflozin Therapy for Type 2 Diabetes

Primary Indications and Clinical Benefits

• The American Diabetes Association recommends dapagliflozin for improving glycemic control in adults with type 2 diabetes as an adjunct to diet and exercise, with additional indications for cardiovascular and renal protection in specific patient populations 1, 2
• Dapagliflozin is indicated for patients with type 2 diabetes who have heart failure to prevent hospitalization for heart failure 3, 2
• The American College of Cardiology recommends dapagliflozin for patients with type 2 diabetes who have chronic kidney disease to minimize CKD progression and reduce cardiovascular events 4, 3
• Dapagliflozin is recommended for patients with type 2 diabetes and established atherosclerotic cardiovascular disease or multiple cardiovascular risk factors to reduce the risk of hospitalization for heart failure 5, 2

Glycemic Efficacy and Safety Considerations

• Dapagliflozin produces HbA1c reductions of approximately 0.5-0.9% when used as monotherapy or add-on therapy 1
• The American College of Cardiology notes that dapagliflozin has a common adverse effect of genital mycotic infections and urinary tract infections 7
• Dapagliflozin has a rare but serious risk of euglycemic diabetic ketoacidosis, especially in vulnerable patients 7

Place in Therapy According to Guidelines

• The American Diabetes Association recommends dapagliflozin as part of glucose-lowering regimen for patients with type 2 diabetes and established ASCVD, heart failure, or CKD, independent of HbA1c levels and metformin use 1, 5
• Dapagliflozin can be considered early in the treatment algorithm for patients with type 2 diabetes who have or are at high risk for cardiovascular or renal complications 6, 3
• The American College of Cardiology suggests that dapagliflozin may be used in combination with GLP-1 receptor agonists for complementary cardiovascular and renal benefits 5, 3