Efficacy and hypoglycemia-related safety of henagliflozin or dapagliflozin as add-on to CSII in hospitalized patients with T2DM: A retrospective matched study using continuous glucose monitoring.

OBJECTIVE

To compare the efficacy and hypoglycemia-related safety of add-on henagliflozin or dapagliflozin to continuous subcutaneous insulin infusion (CSII) versus CSII alone in hospitalized patients with type 2 diabetes mellitus (T2DM).

METHODS

This single-center retrospective study enrolled 322 T2DM inpatients receiving CSII between April 2024 and August 2025. Patients were categorized into three groups based on add-on SGLT2 inhibitor: henagliflozin (10 mg/day), dapagliflozin (10 mg/day), or CSII alone. Propensity score matching (PSM) balanced baseline confounders. Primary outcomes were CGM-derived metrics and hypoglycemic events. Secondary outcomes included extreme glucose values, length of stay, hospitalization costs, and daily insulin dose.

RESULTS

After PSM, 172 patients (58/58/56) had balanced baselines. Compared with CSII alone, both combination groups showed significantly reduced glucose variability, time below range (<3.9 mmol/L), and daily insulin dose, and increased minimum glucose (all p < 0.05). Medication costs were higher in combination groups (p < 0.05), but total hospitalization costs did not differ (p > 0.05). No significant differences were observed in overall or severe hypoglycemia rates (p > 0.05).

CONCLUSION

In hospitalized T2DM patients on CSII, adding henagliflozin or dapagliflozin-despite not improving key efficacy metrics such as time in range (TIR) or reducing hypoglycemia incidence-significantly enhanced glycemic stability and lowered daily insulin requirements, without increasing total hospitalization costs despite higher medication expenses. These findings support henagliflozin as an effective option for optimizing glycemic stability in this setting.