Abstract: Objective  To observe the patients with type 2 diabetes mellitus (T2DM) who had poor glycemiccontrol  (glycosylated hemoglobin,  HbA1c>7.5%)  with metformin alone and the application  effects of dapagliflozinon blood electrolytes (serum sodium,  serum potassium,  serum calcium),  urinary electrolytes(24 hours urinary sodium,  24 hours urinary potassium,  24 hours urinary calcium),  urine osmolality and other metabolic indicators were evaluated  for safety after administration.Methods  During the period  from September 2017 to April 2019,  103 patients with T2DM who were treated in the hospital were randomly divided into control group (n=55) and experimental group (n=48). The control group was treated with metformin,  and the experimental group was given  dapagliflozinmore. The changes of blood electrolytes,  urinary electrolytes,  urine osmolality and other metabolic indexes were compared with the baseline and those in the control group  after 24 weeks of treatment,  and the safety of the medication was evaluated.Results  After 24 weeks of treatment,  the levels of urinary electrolyte and urine osmolality in the experimental group were higher than those in the baseline and the  control group(P<0.05). The blood glucose parameters,  TC,  TG,  24hour urinary protein,  BMI and body weight in the experimental group were lower than those in the baseline and the control group(P<0.05). The levels of serum electrolyte,  urinary pH,  LDLC,  HDLC and eGFR in the experimental group were the same as those in the baseline and control group(P>0.05).Conclusion  In patients with poorly controlled T2DM treated with metformin alone,  the combination of dapagliflozin can reduce blood glucose,  improve blood lipids,  reduce body weight and reduce urinary protein. Although it may cause an increase in urinary electrolytes and inurine osmolality, but there were no significant change in blood electrolyte levels. No serious adverse events occurred,  and it was safe to use.

Key words: diabetes mellitus, , type 2, electrolytes