Abstract： Objective:To investigate the therapeutic effects of dapagliflozin combined with smeglutide in obese patients with type 2 diabetes mellitus(T2DM).Methods:A total of 70 obese T2DM patients admitted to our hospital from February 2021 to November 2022 were selected and divided into two groups,with 35 patients in each group according to the random number table method.Patients in both groups were given metformin(0.5 g/time,3 times/day)and guidance on reasonable diet and identification and management of adverse reactions.The control group received subcutaneous injection of smeglutide into the abdomen before breakfast,with an initial dose of 0.25 mg/time,once per week.After 4 weeks,the dosage doubled to 0.5 mg/time,once per week,and continued for 12 weeks.Based on the above,the observation group received oral dapagliflozin tablets 10 mg/time,once a day,for a continuous period of 12 weeks.Glucose and lipid metabolism indices,weight control,islet function,and adverse reactions were compared between the two groups before and after treatment.Results:Before treatment,there were no significant differences in the glycolipid metabolism index,body weight,body mass index(BMI),and islet function between the two groups(P＞0.05).After treatment,the levels of fasting blood glucose(FPG),2-hour postprandial blood glucose(2 hPG),glycated hemoglobin(HbAlc),low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triglycerides(TG),total body fat mass,body fat rate,body weight,BMI,and insulin resistance index(HOMA-IR)in the two groups were lower than those before treatment,and the observation group was lower than that of the control group.The levels of high-density lipoprotein cholesterol(HDL-C)and islet β-cell function index(HOMA-β)in the two groups were higher than before treatment,and the observation group was higher than the control group,with a statistically significant difference(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusions:The combination of dapagliflozin and smeglutide can improve blood glucose and blood lipid levels,reduce weight,enhance pancreatic islet function,and have fewer adverse reactions in obese T2DM patients.