Triple Therapy for Type 1 Diabetes Investigated

The study found a significant association between the dapagliflozin group and HbA1c reduction
The study found a significant association between the dapagliflozin group and HbA1c reduction

A new study in the Journal of Clinical Endocrinology & Metabolism found that the combination of dapagliflozin, liraglutide, and insulin helped patients with type 1 diabetes improve blood sugar control and lose weight. 

Study authors from the State University of New York at Buffalo investigated whether adding dapagliflozin to insulin and liraglutide led to a significant decrease in glycemia and body weight. They conducted a randomized trial (n=30) at a single academic medical center consisting of patients on liraglutide therapy for at least 6 months. The patients were randomized (2:1) to either dapagliflozin 10mg or placebo daily for 12 weeks. 

The main outcome measure was the change in HbA1c after 12 weeks of dapaglflozin vs. placebo. 

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The results showed a 0.66% decrease in HbA1c from 7.8% in the dapagliflozin treatment group compared to a nonsignificant 0.1% decrease from 7.4% in the placebo group (P<0.01). Body weight was reported to have decreased by 1.9kg (P<0.05) vs. placebo and no additional hypoglycemia was observed (glucose <3.88mmol/L; P=0.52). 

Patients in the dapagliflozin group had significant increases in plasma glucagon levels by 35% (P<0.05), hormone-sensitive lipase levels by 29% (P<0.05)free fatty acids by 74% (P<0.05), acetoacetate by 67% (P<0.05), and β-hydroxybutyrate by 254% (P<0.05). In addition, there was a significant increase in urinary ketone levels. These changes were not seen in the placebo group.

There were also two cases of diabetic ketoacidosis in the dapagliflozin group.

A significant improvement in glycemia and weight loss was seen with the addition of dapagliflozin to insulin and liraglutide in patients with type 1 diabetes. This treatment approach should be used "only a knowledgeable patient along with an endocrinologist who is well versed with it," authors concluded. 

For more information visit endocrine.org.

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