Objective To investigate the effects of canagliflozin on the levels of urinary exosomal miRNA

IL-1β and E-cadherin in patients with type 2 diabetic nephropathy. Methods Forty inpatients with type 2 diabetic nephropathy treated in a hospital in Nanyang from March 2020 to March 2021 were selected for this study

and the patients were divided into an observation group（n=20） and a control group（n=20） using a random number table. Patients in the control group were given oral metformin during meals

and patients in the observation group were given oral canagliflozin before breakfast on the basis of the control group. The fasting plasma glucose（FPG）

2 h postprandial glucose（2hPG）

glycosylated hemoglobin（HbA1c）

Homeostatic model assessment for insulin resistance（HOMA-IR）

and urine albumin-to-creatinine ratio（UACR） were compared before and after treatment in the 2 groups; the levels of urinary exosomal miRNA（miRlet-7 b-5-p

miR320c-

and miR6068-）

IL-1β

and E-cadherin were compared after treatment in the 2 groups. Results Before treatment

there was no statistically significant difference between the levels of FPG

2hPG

HbA1c

HOMA-IR and UACR in the 2 groups（P>0.05）. After treatment

the levels of FPG

2hPG

HbA1c

HOMA-IR and UACR in the 2 groups were lower than those before treatment and lower in the observation group than in the control group

with statistically significant differences（P <0.05）. The levels of urinary exosomal miRlet-7 b-5-p

miR320c-and miR6068-were lower in the observation group than in the control group

and the differences were all statistically significant（P<0.05）. The levels of urinary exosomal IL-1β and E-cadherin were lower in the observation group than in the control group

and the differences were statistically significant（P<0.05）. Conclusion Canagliflozin can reduce FPG

2hPG

HbA1c

HOMA-IR and UACR levels and down-regulate urinary exosomal miRNA expression levels in patients with type 2 diabetic nephropathy

which is helpful for alleviating the disease progression in type2 diabetic nephropathy patients and is worthy of clinical promotion and application.