Twenty inadequately controlled diabetic patients treated with insulin therapy received dapagliflozin treatment for 12 weeks. HbA1C, glycemic variations, plasma 8-iso-prostaglandin F2α(8-PGF2α), and hypersensitive C-reactive protein (hs-CRP) levels, the change of the insulin dose, and the safety of treatments were analyzed. The results showed that after 12-week dapagliflozin therapy, HbA1C, fasting plasma glucose, postprandial 2h plasma glucose, inter-quartile range, standard deviation of blood glucose, large amplitude glycemic excursions, postprandial glucose excursion, as well as absolute means of daily difference were significantly decreased ( P<0. 01) . Compared with those before treatment, addition of dapagliflozin notably decreased plasma 8-PGF2αand hs-CPR levels, along with reduced insulin dosage ( P<0. 01 ) and decreased body weight of patients ( P<0. 05 ) . After dapagliflozin treatment, the hypoglycemia of the patients was obviously improved, without report of severe hypoglycemia. These results indicate that dapagliflozin treatement improves glucose metabolism,and reduces insulin dosage and the hypoglycemic events in fragile diabetics with intensive insulin therapy.

Gut microbiota are closely related to human health. Studies have shown that probiotics, prebiotics and synbiotics play an important role in maintaining intestinal microbiota balance and improving blood glucose, but their use is limited in certain special periods, such as pregnancy, immunodeficiency, and severe infection. Postbiotics is defined as inactivated bacteria and bacterial components that are beneficial for the host, including cell structure, secretory molecules or metabolites and inanimate microorganisms. The heterogeneous molecular metabolite shows a wide range of action mechanisms and plays an important role in restoring intestinal flora and improving blood glucose. This paper reviews the mechanism and research progress of postbiotics regulation of blood glucose.

Diabetic kidney disease (DKD) is one of the most common microvascular complications of diabetes mellitus, with high incidence and disease burden, and has become the main cause of end-stage kidney disease. This article reviews the epidemiological features of DKD, unmet clinical needs, and the progress of prediction model for DKD in detail, by combining the relevant hotspots of the 57 th European Association for the Study of Diabetes scientific annual meeting in an attempt to provide references for the formulation of DKD clinical strategies.