Managing type 2 diabetes mellitus (T2DM) with coexisting hypertension often requires treatment strategies that improve glycemic control while addressing hepatic and renal risk markers. A prospective observational cohort study published in Frontiers in Endocrinology evaluated whether dapagliflozin combined with linagliptin improved time in range (TIR) and metabolic markers compared with monotherapy in this population.
The study included 136 patients aged 40 to 70 years with T2DM (HbA1c 7.5%-11.0%) and hypertension enrolled between June 2021 and September 2024. Participants were allocated equally to standard care, dapagliflozin 10 mg/day, linagliptin 5 mg/day, or combination therapy. Outcomes assessed after 12 weeks included TIR measured by continuous glucose monitoring, blood pressure, lipid parameters, hepatic markers, urinary albumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR).
Findings
Combination therapy achieved the highest TIR compared with monotherapy and standard care (94.86 ± 3.65% vs approximately 80% and 81.44%, respectively; P<0.001).
HbA1c decreased to 5.52%, systolic blood pressure to 124 mmHg, and triglycerides to 0.72 mmol/L in the combination group.
Alanine aminotransferase (ALT) decreased to 9.74 U/L, while UACR decreased to 7.36 mg/g and eGFR increased to 122.41 mL/min/1.73 m².
Higher TIR was associated with more favorable hepatic and renal markers.
Regression analysis identified combination therapy as the strongest predictor of TIR improvement (β=7.896; P<0.001).
The findings suggest that dapagliflozin combined with linagliptin improved glycemic stability and multiple metabolic markers over 12 weeks in patients with T2DM and hypertension.
