Addition of canagliflozin to insulin improves glycemic control and reduces insulin dose in patients with type 2 diabetes mellitus: a randomized controlled trial.

The aim of this study was to evaluate the efficacy of canagliflozin in reducing the required insulin dose and the risk of hypoglycemia in type 2 diabetes (T2D). This study was conducted in patients with T2D treated with insulin. They were randomly assigned to the control (n=17) and canagliflozin (n=17, plus 100 mg/day canagliflozin) groups. In both groups, a defined insulin dose adjustment protocol was applied to achieve the same level of glycemic control. The change from baseline in daily insulin dose was significantly smaller in the canagliflozin group (3.9 units/day) than control group (13.4 units/day; p = 0.040). Low blood glucose index (LBGI) and predicted % of blood glucose (BG) <70 mg/dL, which are hypoglycemia-related parameters, worsened significantly in the control group but both remained unchanged in the canagliflozin group. The standard deviation (SD) for nighttime BG levels improved significantly only in the canagliflozin group. Supplementation of insulin therapy with 100 mg canagliflozin in patients with T2D reduced the required insulin dose and hypoglycemic risk and flattened nighttime glycemic fluctuations while maintaining the same level of glycemic control. This article is protected by copyright. All rights reserved.