Dapagliflozin as additional treatment to liraglutide and insulin in patients with type 1 diabetes
Abstract
CONTEXT: It is imperative that novel approaches to treatment of type 1 diabetes (T1D) are devised. OBJECTIVE: The objective of the study was to investigate whether addition of dapagliflozin to insulin and liraglutide results in a significant reduction in glycemia and body weight. DESIGN: This was a randomized clinical trial. SETTING: The study was conducted at a single academic medical center. PARTICIPANTS: Participants included T1D patients on liraglutide therapy for at least last 6 months. INTERVENTION: Thirty T1D patients were randomized (in 2:1 ratio) to receive either dapagliflozin 10 mg or placebo daily for 12 weeks. MAIN OUTCOME MEASURE: Change in mean glycated hemoglobin after 12 weeks of dapagliflozin when compared with placebo was measured. RESULTS: In the dapagliflozin group, glycated hemoglobin fell by 0.66% ± 0.08% from 7.8% ± 0.21% (P < .01 vs placebo), whereas it did not change significantly in the placebo group from 7.40% ± 0.20% to 7.30% ± 0.20%. The body weight fell by1.9 ± 0.54kg (P < .05 vs placebo). There was no additional hypoglycemia (blood glucose < 3.88 mmol/L; P = .52 vs placebo). In the dapagliflozin group, there were significant increases in the plasma concentrations of glucagon by 35% ± 13% (P < .05), hormone-sensitive lipase by 29% ± 11% (P < .05), free fatty acids by 74% ± 32% (P < .05), acetoacetate by 67% ± 34% (P < .05), and β-hydroxybutyrate by 254% ± 81% (P < .05). Urinary ketone levels also increased significantly (P < .05). None of these changes was observed in the placebo group. Two patients in the dapagliflozin group developed diabetic ketoacidosis. CONCLUSIONS: Addition of dapagliflozin to insulin and liraglutide in patients with T1D results in a significant improvement in glycemia and weight loss while increasing ketosis. 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.
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There is preliminary evidence that in select individuals with type 1 diabetes and excess adiposity, newer pharmacotherapy (GLP-1 receptor agonists or SGLT2 inhibitors) can decrease body weight and improve glycemia, though they are currently not indicated.
“there is preliminary evidence that in select individuals with type 1 diabetes and excess adiposity, newer pharmacotherapy (i.e., glucagonlike peptide 1 receptor agonists or sodium -glucose cotransporter 2 inhibitors) (195,196) can decrease body weight and improve glycemia, though they are currently not indicated.”
From Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report (2019) · cites this paper as [196]
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- Authors
- Kuhadiya, N. D., Ghanim, H., Mehta, A., Garg, M., Khan, S., Hejna, J., Torre, B., Makdissi, A., Chaudhuri, A., Batra, M., & Dandona, P.
- Affiliations
- University at Buffalo, State University of New York (US)
- Corresponding author
- Dandona, Paresh
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2016-09
- Volume
- 101
- Issue
- 9
- Pages
- 3506-3515
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2495972436
- Cited by
- 71
- References
- 20
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 1 · 2023: 7 · 2022: 3 · 2021: 8 · 2020: 11 · 2019: 8 · 2018: 15 · 2017: 6 · 2016: 3
- FWCI
- 10.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- type 1 diabetes, dapagliflozin, liraglutide, insulin therapy, HbA1c, glycemic control, weight loss, glucagon, ketosis, diabetic ketoacidosis, SGLT2 inhibitors, incretin-based therapy, hypoglycemia, free fatty acids, acetoacetate, beta-hydroxybutyrate, urinary ketones
- MeSH terms
- Liraglutide, Adolescent, Adult, Aged, Benzhydryl Compounds, Blood Glucose, Diabetes Mellitus, Type 1, Double-Blind Method, Drug Therapy, Combination, Female, Follow-Up Studies, Glucosides, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Insulin, Male, Middle Aged, Prognosis, Biomarkers, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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