Dapagliflozin and linagliptin combination therapy improves time in range and reverses hepatic steatosis in patients with type 2 diabetes and hypertension.
Type 2 diabetes mellitus (T2DM) with comorbid hypertension increases risks of vascular complications, necessitating optimized therapies. This study evaluated whether dapagliflozin combined with linagliptin improves time in range (TIR) and hepatorenal function compared to monotherapy in this population.
In this prospective observational cohort study at Danzhou People's Hospital (June 2021-September 2024), 136 patients aged 40-70 years with T2DM (HbA1c 7.5-11.0%) and hypertension were allocated to four groups (n=34 each): standard care (control), dapagliflozin (10 mg/day), linagliptin (5 mg/day), or combination therapy. Outcomes after 12 weeks included TIR via continuous glucose monitoring, blood pressure, lipids, hepatic (ALT, AST, liver-to-spleen ratio via CT), and renal parameters (UACR, eGFR). Data were analyzed using ANOVA, correlations, and regression.
Combination therapy achieved superior TIR (94.86 ± 3.65% vs. ~80% in monotherapies and 81.44% in control; P<0.001), with greater reductions in HbA1c (to 5.52%), fasting glucose, blood pressure (systolic to 124 mmHg), lipids (triglycerides to 0.72 mmol/L), liver enzymes (ALT to 9.74 U/L), and UACR (to 7.36 mg/g), plus higher eGFR (to 122.41 mL/min/1.73m²; all P<0.05 vs. others). TIR correlated with improved hepatorenal markers; combination therapy predicted greatest TIR change (β=7.896, P<0.001).
Dapagliflozin-linagliptin combination offers superior glycemic stability and organ protection, supporting its use for managing T2DM with hypertension.
In this prospective observational cohort study at Danzhou People's Hospital (June 2021-September 2024), 136 patients aged 40-70 years with T2DM (HbA1c 7.5-11.0%) and hypertension were allocated to four groups (n=34 each): standard care (control), dapagliflozin (10 mg/day), linagliptin (5 mg/day), or combination therapy. Outcomes after 12 weeks included TIR via continuous glucose monitoring, blood pressure, lipids, hepatic (ALT, AST, liver-to-spleen ratio via CT), and renal parameters (UACR, eGFR). Data were analyzed using ANOVA, correlations, and regression.
Combination therapy achieved superior TIR (94.86 ± 3.65% vs. ~80% in monotherapies and 81.44% in control; P<0.001), with greater reductions in HbA1c (to 5.52%), fasting glucose, blood pressure (systolic to 124 mmHg), lipids (triglycerides to 0.72 mmol/L), liver enzymes (ALT to 9.74 U/L), and UACR (to 7.36 mg/g), plus higher eGFR (to 122.41 mL/min/1.73m²; all P<0.05 vs. others). TIR correlated with improved hepatorenal markers; combination therapy predicted greatest TIR change (β=7.896, P<0.001).
Dapagliflozin-linagliptin combination offers superior glycemic stability and organ protection, supporting its use for managing T2DM with hypertension.