Is dapagliflozin an effective treatment for type 1 diabetes?

This study looked at the use of dapagliflozin (Forxiga) in the treatment of type 1 diabetes (T1D). It found that compared to placebo, dapagliflozin resulted in a better blood glucose control, a reduction in body weight, and a reduced insulin dose.

T1D is a disease caused by the inability of the pancreas to produce insulin. Insulin is needed to introduce glucose from the blood into cells for energy. Therefore, the blood glucose (sugar) is very high in T1D. In these patients, insulin is given by injection instead, in order to reduce blood glucose levels. However insulin can cause blood sugar to go too low, so it is better to use as little insulin as required. It also leads to weight gain.

Other medications have been developed as add-ons to insulin treatment to help control blood glucose and reduce the need for insulin. Dapagliflozin is one of these medications. Dapagliflozin works by increasing the amount of glucose excreted by the kidneys. However, it is not clear how much dapagliflozin helps in patients with T1D.

Five studies involving a total of 1,576 patients were reviewed for this study. Patients were treated with either dapagliflozin or placebo as add-ons to insulin treatment. 

Compared to those treated with placebo, patients treated with dapagliflozin showed an average reduction in HbA1c (a measure of blood glucose control over 2-3 months) of 0.36%. Dapagliflozin-treated patients also showed an average reduction in body weight of 4.02%. The dapagliflozin group showed a reduction in their daily insulin dose of 10.36%. 

Patients treated with dapagliflozin had a higher quantity of glucose removed through urine over 24 hours (by 90.02g/24h) compared to placebo.

This study showed that compared to placebo, dapagliflozin treatment leads to a reduction in body weight, a better blood glucose control, and lower insulin requirement in patients with T1D.

Four out of five studies were funded by companies that produce dapagliflozin.