Could dapagliflozin be a complement to insulin therapy in type 1 diabetes?

This study investigated the potential of dapagliflozin (Farxiga) as an add-on treatment to insulin therapy. The authors concluded that dapagliflozin was safe and helped improve glycemic outcomes in those with uncontrolled type 1 diabetes.

 

 

Insulin is a hormone which helps control blood sugar levels. Patients with type 1 diabetes (T1D) do not produce enough insulin. They thus need to use synthetic insulin to help control their blood sugar. Insulin therapy, however, may lead to side effects. These include: weight gain (which in turn can lead to high blood pressure), hypoglycemia (dangerously low blood sugar) and diabetic ketoacidosis (DKA, a potentially dangerous condition resulting in extremely high blood sugar). Scientists have thus begun to look for a non-insulin treatment to complement insulin therapy. Dapagliflozin has been shown to be effective at controlling blood sugar in type 2 diabetes. It is unclear, however, whether or not dapagliflozin would be an effective add-on treatment for T1D patients.

 

 

This study assessed whether patients treated with dapagliflozin (in addition to their normal insulin) could safely improve their glycemic control. All patients had an initial HbA1C (average blood glucose over 3 months) above 7.7%. In addition to their normal insulin, patients received either once-daily 5 mg dapagliflozin (259 patients), once-daily 10 mg dapagliflozin (259 patients) or a placebo (substance with no active effect; 260 patients). Treatment lasted for 24 weeks. 

 

Compared to the placebo, the 5 mg treatment reduced HbA1C levels by 0.42% and the 10 mg reduced HbA1C levels by 0.45%. Both doses also resulted in weight loss (slightly higher for the 10 mg treatment) during this period. There was no differences in side effects (including hypoglycemia and DKA) between the treatment group and the control group.

 

 

This study concluded that dapagliflozin may be an effective add-on treatment to insulin therapy in cases of uncontrolled T1D.

 

 

Longer trials are needed to confirm these findings.

 

 

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