Efficacy of Low-dose Dapagliflozin in Young People with Type 1 Diabetes

Objective Young people with type 1 diabetes are likely to gain body weight and not achieve optimal glyce-mic control with only high doses of insulin. This study examined the efficacy of the sodium-glucose cotrans-porter 2 (SGLT2) inhibitor dapagliflozin as an adjunct-to-insulin therapy in young Japanese subjects with type 1 diabetes who had been diagnosed before 15 years old, were overweight, and had inadequate control despite receiving intensive insulin therapy.Methods Twenty-two patients with type 1 diabetes (12 boys and 10 girls 16.0-33.9 years old) were in-volved in the study. All patients had a body mass index (BMI) >25 kg/m2, glycated hemoglobin (HbA1c) level >7.0%, and daily insulin dose >0.5 units/kg. They were treated with a low dose of dapagliflozin (5.0 mg/day) as an adjunctive therapy to insulin. Fourteen patients were treated with multiple daily injections of insulin, while eight used an insulin pump.Results The body weights and BMIs were significantly reduced during the 12-month study period (change of-4.4 kg and-1.7 kg/m2, p<0.001, respectively). Their insulin dose was significantly decreased (-0.17 units/ kg, P <0.001), and glycemic control was significantly improved (fasting plasma glucose:-18.7 mg/dL, HbA1 c:-0.62%, p<0.001) during the study period. There was one episode of diabetic ketoacidosis, with no other problematic adverse events, including severe hypoglycemia, observed.Conclusion The use of low-dose dapagliflozin as an adjunct therapy may be beneficial in overweight young people with poorly controlled type 1 diabetes.

Automated summary

This study examined the efficacy of the SGLT2 inhibitor dapagliflozin as an adjunct-to-insulin therapy in young Japanese subjects with type 1 diabetes who were diagnosed before 15 years old, were overweight, and had inadequate control despite intensive insulin therapy.