Study Investigates Addition of Dapagliflozin to Insulin in T1DM Treatment
HealthDay News — For patients with type 1 diabetes (T1D), the addition of dapagliflozin to insulin and liraglutide is associated with significant improvement in glycemia and weight loss, according to a study published online August 4 in the Journal of Clinical Endocrinology & Metabolism.
Nitesh D. Kuhadiya, MD, from the State University of New York at Buffalo, and colleagues conducted a randomized trial involving 30 patients with T1D on liraglutide therapy for at least 6 months. Participants were randomized in a 2:1 ratio to receive dapagliflozin or placebo for 12 weeks.
The researchers observed a 0.66% decrease in glycated hemoglobin in the dapagliflozin group and no significant change in the placebo group (P<0.01 versus placebo). Body weight decreased by 1.9 ± 0.54 kg in the dapagliflozin group (P<0.05 versus placebo). No additional hypoglycemia was seen in the dapagliflozin group (P=0.52 versus placebo). There were significant increases in the plasma concentrations of glucagon, hormone-sensitive lipase, free fatty acids, acetoacetate, and β-hydroxybutyrate in the dapagliflozin group (all P<0.05); there was also a significant increase in urinary ketone levels (P<0.05). None of these changes were seen in the placebo group. Diabetic ketoacidosis developed in two patients in the dapagliflozin group.
"Addition of dapagliflozin to insulin and liraglutide in patients with T1D results in a significant improvement in glycemia and weight loss while increasing ketosis," the authors write. "If it is decided to use this approach, then it must be used only by a knowledgeable patient along with an endocrinologist who is well versed with it."
Several authors disclosed financial ties to pharmaceutical companies, including Astra Zeneca and Bristol-Meyers Squibb, both which were involved in the development of dapagliflozin.