Abstract:ObjectiveTo analyze the effects of dapagliflozin on blood glucose levels, renal function, and the levels of miR-21-5p and miR-423-5p in patients with diabetic nephropathy. Methods A total of 98 patients with diabetic nephropathy admitted in The Second People's Hospital of Hefei from February 2022 to October 2023 were selected and divided into the control group (n=49) and the observation group (n=49) according to the random number table method. The control group was treated with metformin, and the observation group was treated with a combination of metformin and dapagliflozin. Blood glucose levels, renal function, expression levels of miR-21-5p, miR-423-5p and serum proinflammatory factors before and after treatment were compared between the two groups, and the incidence of adverse reactions was recorded. Results The levels of fasting blood glucose (FBG), glycated hemoglobin (HbA1c), and serum creatinine (Scr), blood urea nitrogen (BUN), cystatin C (Cys-C) in both groups decreased after 3 months of treatment, and the above indexes in the observation group were lower than those in the control group (P<0.05). Similarly, levels of miR-21-5p, miR-423-5p, C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were significantly lower in the observation group compared to the control group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group (12.24% vs 6.12%, P>0.05). Conclusion Daglipzin can help improve the blood sugar level and renal function of patients with diabetes nephropathy, reduce the expression of miR-21-5p, miR-423-5p and the level of serum proinflammatory factors, with good safety.