SYSTEMATIC REVIEW article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1514783
Dapagliflozin Combined with Methylcobalamin in the Treatment of Type 2 Diabetes Mellitus with Peripheral Neuropathy: A Systematic Review and Meta-analysis
Provisionally accepted
- ZhongShan’s Chenxinhai Integrated Chinese and Western Medicine Hospital, Zhongshan, China
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Background: Type 2 diabetes mellitus (T2DM) is a prevalent chronic metabolic disorder, with diabetic peripheral neuropathy (DPN) being one of its most common complications. Current treatments primarily aim at glycemic control and symptom relief, yet long-term efficacy is often insufficient. Dapagliflozin, an SGLT-2 inhibitor, and methylcobalamin, the active form of vitamin B12, have demonstrated potential in managing DPN. This systematic review assesses the efficacy and safety of their combined use.: This study synthesized randomized controlled trials (RCTs) from major databases up to the September 30, 2024, focusing on dapagliflozin combined with methylcobalamin for treating DPN in T2DM patients.Statistical analysis was performed using RevMan 5.4. The risk of bias was assessed with the Cochrane Risk of Bias 2.0 (ROB 2.0) tool. Outcomes included the overall effective rate (OER), common peroneal motor nerve conduction velocity (CPMNCV), common peroneal sensory nerve conduction velocity (CPSNCV), median motor nerve conduction velocity (MMNCV), and median sensory nerve conduction velocity (MSNCV), fasting plasma glucose (FPG), 2-hour postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), and rate of adverse events (RAE). Results: Seven RCTs met inclusion criteria. The combination therapy significantly improved OER (odds ratio (OR): 5.05; 95% confidence interval (CI): 2.60-9.81), CPMNCV (MD: 3.93 m/s; 95% CI: 2.16-5.70; P<0.01), CPSNCV (MD: 3.36 m/s; 95% CI: 2.74-3.98; P<0.01), MMNCV (MD: 4.71 m/s; 95% CI: 3.90-5.52; P<0.01), and MSNCV (MD: 3.05 m/s; 95% CI: 2.19-3.90; P<0.01). Glycemic control also improved, with reductions in FPG (MD, 95%
Keywords: Diabetic peripheral neuropathy, type 2 diabetes mellitus, dapagliflozin, Methylcobalamin, Systematic review
Received: 21 Oct 2024; Accepted: 05 May 2025.
Copyright: © 2025 Deng, Wu, Lin, Liang and Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Han-wei Huang, ZhongShan’s Chenxinhai Integrated Chinese and Western Medicine Hospital, Zhongshan, China
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