OBJECTIVE The aim of this case-control study was to assess the efficacy of dapagliflozin combined with metformin for type-2 diabetes mellitus (T2DM) with obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS A total of 36 patients with newly-diagnosed T2DM and OSAHS were randomized divided into two groups. Eighteen OSAHS patients with T2DM, who were treated with dapagliflozin and metformin, were assigned as the dapagliflozin group. These patients were given dapagliflozin and metformin for 24 weeks between February 2017 and February 2018. Another 18 OSAHS patients with T2DM, who were treated with glimepiride and metformin for 24 weeks, were assigned as the control group. Fasting plasma glucose (FPG) level, postprandial blood glucose (PPG), hemoglobin A1C (HbA1c), fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), blood lipids, body mass index (BMI), blood pressure, apnea-hypopnea index (AHI), minimum oxygen saturation (LSpO2), and Epworth Somnolence Scale (ESS) score were measured before and at 24 weeks after the initiation of treatment. RESULTS In the dapagliflozin group, triglyceride (TG), systolic pressure (SBP) and diastolic pressure (DBP) significantly decreased following treatment, while high-density lipoprotein cholesterol (HDL-C) significantly increased (P < 0.05). Furthermore, a reduction in AHI, an increase in LSpO2 and a decrease in ESS score were observed in the dapagliflozin group (P < 0.05), but not in the control group. Moreover, blood glucose, HbA1c, HOMA-IR, and BMI significantly decreased in these two groups, and the decrease was more significant in the dapagliflozin group. CONCLUSION These present results indicate that dapagliflozin can significantly reduce glucose, BMI, blood pressure and AHI, and improve hypoxemia during sleep and excessive daytime sleepiness, which thereby has potential as an effective treatment approach for OSAHS.

中文翻译：

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达格列净对2型糖尿病患者阻塞性睡眠呼吸暂停的影响：一项初步研究。

目的本病例对照研究的目的是评估达格列净联合二甲双胍对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的2型糖尿病（T2DM）的疗效。方法将36例新诊断为T2DM和OSAHS的患者随机分为两组。将18例接受达格列净和二甲双胍治疗的OSAHS T2DM患者分为达格列净组。这些患者在2017年2月至2018年2月之间接受达格列净和二甲双胍治疗24周。将另外18例接受格列美脲和二甲双胍治疗24小时的OSAHS T2DM患者作为对照组。空腹血糖（FPG），餐后血糖（PPG），血红蛋白A1C（HbA1c），空腹胰岛素，胰岛素抵抗稳态模型评估（HOMA-IR），在治疗开始前和治疗后第24周测量血脂，体重指数（BMI），血压，呼吸暂停低通气指数（AHI），最低氧饱和度（LSpO2）和爱泼华嗜睡量表（ESS）评分。结果在达格列净组中，治疗后甘油三酸酯（TG），收缩压（SBP）和舒张压（DBP）显着降低，而高密度脂蛋白胆固醇（HDL-C）显着升高（P <0.05）。此外，在达格列净组中观察到AHI降低，LSpO2升高和ESS评分降低（P <0.05），而对照组则没有。此外，这两组血糖，HbA1c，HOMA-IR和BMI均显着降低，而达格列净治疗组的降低更为显着。