In a nutshell
The aim of this study was to assess continuous blood glucose levels in patients with type 1 diabetes (T1D) taking dapagliflozin as an add-on to insulin treatment. The main finding of the study was that patients treated with dapagliflozin had improved average blood glucose levels and less variation in blood glucose levels.
Some background
The aim of treatment in T1D is to normalize blood glucose. Currently, this is done by using insulin injections. The side effects of insulin are weight gain and blood glucose dropping too low (hypoglycemia). Large changes in glucose levels throughout the day is called glucose variability (GV). Large GV is associated with complications of diabetes such as heart, kidney and eye disease. Ideally, blood glucose should stay in a target range of 3.9-10 mmol/L.
Dapagliflozin (Farxiga) is a blood glucose-lowering drug used in the treatment of type 2 diabetes. It is an SGLT2 inhibitor. It works by blocking the uptake of sugar in the kidney back into the blood. Instead, the glucose gets removed from the body in the urine. Recent studies have shown that using dapagliflozin in addition to insulin improved glucose control in T1D. The effect of dapagliflozin on GV in patients with T1D is not known.
Methods & findings
This study included 1,591 patients with T1D. Patients received either 5mg dapagliflozin, 10mg dapagliflozin or a placebo for 24 weeks. Blood glucose levels were monitored continuously.
Patients receiving 5mg and 10mg dapagliflozin spent more time over 24hr in the target range than those receiving the placebo. After 24 weeks, patients receiving dapagliflozin had improved average blood sugar levels and average GV compared to those receiving the placebo. There were no differences in the amount of time spent below target range (hypoglycemia) between all three groups.
The bottom line
The authors concluded that treatment with dapagliflozin added to insulin therapy improved time spent in target range and GV in patients with T1D, without increasing the risk of hypoglycemia.
The fine print
This study was funded by AstraZeneca, the developer of dapagliflozin.
Published By :
Diabetes Care
Date :
Apr 09, 2019
