{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T22:51:20Z","timestamp":1774047080176,"version":"3.50.1"},"reference-count":31,"publisher":"American Diabetes Association","issue":"8","license":[{"start":{"date-parts":[[2019,7,22]],"date-time":"2019-07-22T00:00:00Z","timestamp":1563753600000},"content-version":"vor","delay-in-days":48,"URL":"http:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,8,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>This study evaluated whether an oral combination of a sodium\u2013glucose cotransporter 2 inhibitor and a dipeptidyl peptidase 4 inhibitor achieved glycemic control similar to basal insulin in patients with type 2 diabetes, poorly controlled with metformin, without increasing hypoglycemia or body weight.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>In a multinational, open-label, randomized, phase 3 trial (ClinicalTrials.gov reg. no. NCT02551874), adults with type 2 diabetes inadequately controlled on metformin, with or without sulfonylurea, were randomized (1:1) to receive dapagliflozin (DAPA) plus saxagliptin (SAXA) or titrated insulin glargine (INS). The primary end point was change in glycated hemoglobin A1c (HbA1c) from baseline to week 24. DAPA + SAXA treatment was tested for noninferiority versus INS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The efficacy data set included 643 patients (mean \u00b1 SD HbA1c, 9.1 \u00b1 1.0% [75 \u00b1 11 mmol\/mol]). At week 24, DAPA + SAXA treatment versus INS resulted in noninferior reductions in HbA1c (adjusted mean \u00b1 SE change, \u22121.7 \u00b1 0.1% vs. \u22121.5 \u00b1 0.1% [18.3 \u00b1 0.7 mmol\/mol vs. 16.8 \u00b1 0.7 mmol\/mol]; P = 0.118), significantly different body weight change (between-group difference, \u22123.64 kg [95% CI \u22124.20 to \u22123.09]; P &amp;lt; 0.001), fewer patients with confirmed hypoglycemia (21.3% vs. 38.4%, P &amp;lt; 0.001), more patients achieving HbA1c &amp;lt;7.0% (53 mmol\/mol) without hypoglycemia (20.9% vs. 13.1%, P = 0.008), and a similar proportion of patients achieving HbA1c &amp;lt;7.0% (33.2% vs. 33.5%, P = 0.924). Mean reductions in 24-h glucose measurements from baseline to week 2 were greater with DAPA + SAXA than with INS (P &amp;lt; 0.0001). No patients in the DAPA + SAXA group and three patients (0.9%) in the INS group experienced severe hypoglycemia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Adding DAPA + SAXA to insulin-naive patients with poorly controlled type 2 diabetes achieved similar glycemic control, a lower risk of hypoglycemia, and a clinically relevant body weight difference compared with basal INS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc18-1988","type":"journal-article","created":{"date-parts":[[2019,6,5]],"date-time":"2019-06-05T04:05:34Z","timestamp":1559707534000},"page":"1464-1472","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":16,"title":["Dapagliflozin Plus Saxagliptin Add-on Therapy Compared With Insulin in Patients With Type 2 Diabetes Poorly Controlled by Metformin With or Without Sulfonylurea Therapy: A Randomized Clinical Trial"],"prefix":"10.2337","volume":"42","clinical-trial-number":[{"clinical-trial-number":"nct02551874","registry":"10.18810\/clinical-trials-gov","type":"results"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0456-6787","authenticated-orcid":false,"given":"Tina","family":"Vilsb\u00f8ll","sequence":"first","affiliation":[{"name":"Steno Diabetes Center Copenhagen, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ella","family":"Ekholm","sequence":"additional","affiliation":[{"name":"AstraZeneca Gothenburg, M\u00f6lndal, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Johnsson","sequence":"additional","affiliation":[{"name":"AstraZeneca Gothenburg, M\u00f6lndal, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nalina","family":"Dronamraju","sequence":"additional","affiliation":[{"name":"AstraZeneca, Gaithersburg, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4080-0470","authenticated-orcid":false,"given":"Serge","family":"Jabbour","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Thomas Jefferson University Hospital, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3796-9283","authenticated-orcid":false,"given":"Marcus","family":"Lind","sequence":"additional","affiliation":[{"name":"Institute of Medicine, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1167","published-online":{"date-parts":[[2019,6,4]]},"reference":[{"key":"2022031300020671600_B1","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.2337\/dc12-0413","article-title":"Management of hyperglycemia in type 2 diabetes: a patient-centered approach: position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)","volume":"35","author":"Inzucchi","year":"2012","journal-title":"Diabetes Care"},{"key":"2022031300020671600_B2","doi-asserted-by":"crossref","first-page":"140","DOI":"10.2337\/dc14-2441","article-title":"Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes","volume":"38","author":"Inzucchi","year":"2015","journal-title":"Diabetes Care"},{"key":"2022031300020671600_B3","doi-asserted-by":"crossref","first-page":"207","DOI":"10.4158\/EP161682.CS","article-title":"Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm \u2013 2017 executive summary","volume":"23","author":"Garber","year":"2017","journal-title":"Endocr Pract"},{"key":"2022031300020671600_B4","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1007\/s12020-016-0943-4","article-title":"SGLT2 inhibitors in the management of type 2 diabetes","volume":"53","author":"Monica Reddy","year":"2016","journal-title":"Endocrine"},{"key":"2022031300020671600_B5","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1111\/dom.12591","article-title":"Incretin therapies: highlighting common features and differences in the modes of action of glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors","volume":"18","author":"Nauck","year":"2016","journal-title":"Diabetes Obes Metab"},{"key":"2022031300020671600_B6","doi-asserted-by":"crossref","first-page":"2669","DOI":"10.2337\/dci18-0033","article-title":"Management of hyperglycemia in type 2 diabetes, 2018. 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