Objective To investigate the effect of dapagliflozin in the treatment of elderly patients with type 2 diabetes mellitus combined with heart failure with reduced ejection fraction (HFrEF). Methods A total of 80 elderly patients with type 2 diabetes mellitus combined with HFrEF were selected as the study subjects and randomly divided into a dapagliflozin group or a control group, with 40 cases in each group. The control group was treated with standardized conventional treatment, based on which the dapagliflozin group was treated with dapagliflozin additionally, and both groups were treated for 6 months. The efficacy; laboratory indexes, cardiac color ultrasound indexes, 6-minute walk test distance, and the MOS 36-item short-form health survey (SF-36) score before and after the 6-month treatment; and rehospitalization rate and occurrence of adverse reactions during the treatment were compared between the two groups. Results The total therapeutic effective rate of the dapagliflozin group was higher than that of the control group (95.00% vs. 80.00%, P<0.05). Before the treatment, there was no statistically significant difference in the fasting blood glucose (FBG) level, 2-hour postprandial blood glucose (2hPBG) level, glycosylated hemoglobin (HbA1c) level, N-terminal probrain natriuretic peptide (NT-proBNP) level, left ventricular end-systolic diameter (LVESd), left ventricular end-diastolic diameter (LVEDd), left ventricular ejection fraction (LVEF), 6-minute walk test distance, or SF-36 score between the two groups (all P>0.05). After 6 months of treatment, the levels of FBG, 2hPBG, HbA1c, and NT-proBNP; LVEDd; and LVESd were decreased in the two groups, and the above indexes levels in the dapagliflozin group were lower than those in the control group (all P<0.05). The LVEF, 6-minute walk test distance, and SF-36 score were increased/prolonged in both groups, and the LVEF, 6-minute walk test distance, and SF-36 score in the dapagliflozin group were longer/higher than those in the control group (all P<0.05). During the treatment, the rehospitalization rate of the dapagliflozin group (7.50%) was lower than that of the control group (30.00%) (χ2=6.646, P=0.010); there was no serious adverse reaction in the two groups. Conclusion On the basis of standardized treatment, dapagliflozin treatment in elderly patients with type 2 diabetes mellitus combined with HFrEF can significantly improve heart failure, control blood glucose levels, reduce the rehospitalization rate, and promote the improvement of patients' quality of life.

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