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OBJECTIVE: To probe into the efficacy of dapagliflozin combined with insulin glargine in the treatment of patients with diabetes mellitus type 2 (T2DM) and its effects on blood glucose variability and pancreatic islet function. METHODS: A total of 98 patients with T2DM admitted into the hospital from Jan. 2019 to Jan. 2023 were divided into the observation group and control group via the simple randomized grouping method, with 49 cases in each group. The control group was treated with insulin glargine; while the observation group was given dapagliflozin combined with insulin glargine. After 3 months of treatment, the clinical efficacy, blood glucose indicators, blood glucose variability, pancreatic islet function indicators and blood lipid indicators before treatment and after 3 months of treatment, the incidences of adverse drug reactions were compared between two groups. RESULTS: After 3 months of treatment, the total effective rate of the observation group [98. 0%(48/49)] was significantly higher than that of the control group [85. 7%(42/ 49)], with statistically significant difference (P<0. 05). After 3 months of treatment, the fasting blood glucose, 2 h postprandial blood glucose, glycosylated hemoglobin, 24 h mean blood glucose, maximum amplitude of blood glucose, mean amplitude of glycemic excursions in 1 d, variable coefficient of blood glucose, variable coefficient of fasting blood glucose, insulin resistance index, total cholesterol, low-density lipoprotein cholesterol and triglyceride levels in both groups were significantly lower than those before treatment, and the observation group was significantly lower than the control group, with statistically significant differences (P<0. 05); the homeostasis model assessment-β, insulin sensitivity index and high-density lipoprotein cholesterol of both groups were significantly higher than those before treatment, and the observation group was higher than the control group, with statistically significant differences (P<0. 05). During the treatment period, the total incidences of adverse drug reactions of the observation group and the control group were respectively 22. 4% (11/49) and 10. 2% (5/49), the difference was not statistically significant (P>0. 05). CONCLUSIONS: Dapagliflozin combined with insulin glargine has significant efficacy in the treatment of patients with T2DM, which can significantly improve blood glucose control, enhance pancreatic islet function and regulate blood lipid levels with higher safety. [ABSTRACT FROM AUTHOR]