Dapagliflozin Added to Regimen Boosts Glycemic Control in Type 1 Diabetes

The findings of improved glycemic control but some incidence of diabetic ketoacidosis are consistent with other early findings of use of SGLT2 inhibitors in type 1 diabetes.

A study involving the SGLT2 inhibitor dapagliflozin has found that adding the therapy to insulin and liraglutide is associated with improved glycemic control for patients with type 1 diabetes (T1D). Patients also lost weight.

Findings published recently in the Journal of Clinical Endocrinology and Metabolism were based on a study of 30 patients with T1D. The use of sodium glucose co-transporter 2 (SGLT2) inhibitors for T1D patients has drawn recent interest, and research in this area was featured at a session of the American Diabetes Association in June.

All the patients in the study had been taking liraglutide along with their insulin therapy for at least 6 months. They were randomized to receive either a 10 mg dose of dapagliflozin or placebo for 12 weeks.

Researchers reported a 0.66% decrease in glycated hemoglobin (A1C) in the dapagliflozin group and no significant change in the group taking placebo. Patients taking dapagliflozin lost an average of 1.9 kg, with no additional hypoglycemia.

Results also showed significant increases in the plasma concentrations of glucagon, free fatty acids, acetoacetate, and β-hydroxybutyrate in the dapagliflozin group. However, 2 patients in taking the study group developed diabetic ketoacidosis, which was reported in a study involving another SGLT2 inhibitor, canagliflozin, in T1D patients.

At the ADA session, researchers said SGLT2 inhibitors may provide a path away from the rapid fluctuations in blood glucose, which are a hallmark of T1D.

Reference

Kuhadya ND, Ghanim H, Mehta A, et al. Dapagliflozin as additional treatment to liraglutide and insulin in patients with type 1 diabetes [published online August 4, 2016]. J Clin Endocrinol Metab. 2016; http://dx.doi.org/10.1210/jc.2016-1451