Dapagliflozin as an adjunct for ascites and glycemic control in patients with decompensated cirrhosis and diabetes: A retrospective cohort study
Praveen Sharma, Anil Arora, Ashish Kumar
A
BSTRACT
Introduction:
Evidence supporting sodium-glucose cotransporter 2 (SGLT2) inhibitors in decompensated cirrhosis remains limited. We evaluated dapagliflozin as an adjunct for ascites control and glycemic management in patients with decompensated cirrhosis and diabetes.
Methods:
This retrospective single-center cohort included 31 consecutive patients who started dapagliflozin 5–10 mg/day between January and October 2024 and were followed for six months. Ascites grade, large-volume paracentesis (LVP), diuretic dose, renal function, serum sodium, mean arterial pressure (MAP), liver biochemistry, and glycated hemoglobin (HbA1c) were assessed longitudinally.
Results:
Mean age was 48.5 ± 5.7 years and 27 patients were male. The distribution of mild: moderate: severe ascites improved from 0:14:17 at baseline to 22:9:0 at six months (
Conclusion:
In carefully selected patients with decompensated cirrhosis and diabetes, dapagliflozin was associated with improved ascites control without an observed renal, sodium, or hemodynamic safety signal. These findings are hypothesis-generating and do not support routine use until larger controlled studies establish efficacy and safety.