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Efficacy and Safety of Dapagliflozin in Patients With Inadequately Controlled Type 1 Diabetes (the DEPICT-2 Study): 24-Week Results From a Randomized Controlled Trial
Abstract
Objective This 24-week, double-blinded, phase 3 clinical trial (DEPICT-2; ClinicalTrials.gov, NCT02460978) evaluated efficacy and safety of dapagliflozin as adjunct therapy to adjustable insulin in patients with inadequately controlled type 1 diabetes (HbA 1c 7.5-10.5%). Research design and methods Patients were randomized 1:1:1 to dapagliflozin 5 mg ( n = 271), dapagliflozin 10 mg ( n = 270), or placebo ( n = 272) plus insulin. Insulin dose was adjusted by investigators according to self-monitored glucose readings, local guidance, and individual circumstances. Results Baseline characteristics were balanced between treatment groups. At week 24, dapagliflozin significantly decreased HbA 1c (primary outcome; difference vs. placebo: dapagliflozin 5 mg -0.37% [95% CI -0.49, -0.26], dapagliflozin 10 mg -0.42% [-0.53, -0.30]), total daily insulin dose (-10.78% [-13.73, -7.72] and -11.08% [-14.04, -8.02], respectively), and body weight (-3.21% [-3.96, -2.45] and -3.74% [-4.49, -2.99], respectively) ( P 70 to ≤180 mg/dL) versus placebo were significantly improved. More patients receiving dapagliflozin achieved a reduction in HbA 1c ≥0.5% without severe hypoglycemia compared with placebo. Adverse events were reported for 72.7%, 67.0%, and 63.2% of patients receiving dapagliflozin 5 mg, dapagliflozin 10 mg, and placebo, respectively. Hypoglycemia, including severe hypoglycemia, was balanced between groups. There were more adjudicated definite diabetic ketoacidosis (DKA) events with dap…
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“Use of these processes may have contributed to the lower rates of ketoacidosis seen in some of the studies of these agents for adjunctive glycemic management in people with type 1 diabetes (314-316) compared with those that did not include preventative strategies (310,317).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [315]
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Metadata
- Authors
- Mathieu, C., Dandona, P., Gillard, P., Senior, P., Hasslacher, C., Araki, E., Lind, M., Bain, S. C., Jabbour, S., Arya, N., Hansen, L., Thorén, F., Langkilde, A. M., DEPICT-2 Investigators, Luquez, C., Manghi, F. P., Ulla, M. R., Moisello, M. A., Visco, V., De Lapertoza, S. G., Solis, S. E., Farias, J., Sposetti, G., Gillard, P., Abrams, P., van Ypersele de Strihou, M., Conway, J., Pedersen, S., Senior, P., Liutkus, J. F., Yip, C.-E., Punthakee, Z., Bernier, F., Lochnan, H., Woo, V., Elliott, T., Palma, J., Merino, C. S., Vargas, A. D., Wendisch, U., Reichel, A., Seufert, J., Becker, B., Alawi, H., Birkenfeld, A. L., Hasslacher, C., Luedemann, J., Schaum, T., Marck, C., Sauter, J., Aigner, U., Onishi, Y., Seino, H., Sato, Y., Nunoi, K., Yamauchi, A., Nakashima, E., Ikeda, H., Shiraiwa, T., Yamasaki, Y., Yokoyama, H., Nakamura, K., Noritake, M., Miyauchi, S., Hakoda, T., Hirohata, Y., Hasegawa, A., Fukumoto, Y., Nagashima, H., Takihata, M., Kamada, T., Jinnouchi, H., Ono, Y., Watanabe, T., Ohashi, H., Takai, M., Seguchi, T., Yamazaki, K., Maeda, H., Iwasaki, S., De Valk, H. W., Kooy, A., Landewe-Cleuren, S., Madziarska, K., Stankiewicz, A., Wasilewska, K., Rudofsky, G., Malecki, M., Pankowska, E., Szyprowska, E., Lukaszewicz, M., Tokarska, L., Bondar, I., Karpova, I., Ruyatkina, L., Zalevskaya, A., Sardinov, R., Khalimov, Y., Sjoberg, F., Koskinen, P., Curiac, D., Lind, M., Bach-Kliegel, B., Schultes, B., Issa, B. G., Kilvert, A., Pereira, O., Bain, S., Mishra, B., Bhatnagar, D., Chuck, L., Gorson, D., Robertson, D., Casaubon, L., Chaykin, L., Frias, J. P., Hsia, S., Jenders, R., Lerman, S., Segel, S., Weissman, P., Chang, A., Reed, J., Madu, I.-J., Bressler, P., Abbott, L., Gangi, S., Wheeler, K., Cohen, K., Biggs, W., Jabbour, S., Karounos, D., Menon, S., Miers, W., Aleppo, G., Lefebvre, G., Sugimoto, D., Ferraro, R., Kelly, R., Twahirwa, M., Case, C., Klonoff, D., Denker, P., Hollander, P., Welch, M., Leinung, M., Kotek, L., McGill, J., Shlesinger, Y., Huffman, C., Aronoff, S., Lorber, D., Terrelonge, A., Akhrass, F., Bredefeld, C., Hershon, K., Lenhard, J., Donovan, D., Stonesifer, L., Greenberg, C., Ipp, E., Bhargava, A., & Bao, S.
- Affiliations
- KU Leuven (BE)
- University at Buffalo, State University of New York (US)
- Kumamoto University (JP)
- Diabetes Research Unit, Swansea University, Swansea, Wales, U.K.
- AstraZeneca (United States) (US)
- MedImmune, Gaithersburg, MD
- AstraZeneca, Gothenburg, Sweden
- AstraZeneca (Sweden) (SE)
- University of Alberta (CA)
- Diabetesinstitut Heidelberg (DE)
- NU Hospital Group (SE)
- Swansea University (GB)
- Thomas Jefferson University (US)
- Corresponding author
- Mathieu, Chantal
- ORCID
- Mathieu, Chantal
- Dandona, Paresh
- Araki, Eiichi
- Hansen, Lars
- Langkilde, Anna Maria
- Pedersen, Sue
- Punthakee, Zubin
- Lochnan, Heather
- Woo, Vincent
- Elliott, Thomas
- Reichel, Andreas
- Seufert, Jochen
- Birkenfeld, Andreas L.
- Onishi, Yukiko
- Seino, Hiroaki
- Sato, Yuichi
- Nunoi, Kiyohide
- Ikeda, Hiroki
- Yokoyama, Hiroki
- Miyauchi, Shozo
- Hasegawa, Atsushi
- Jinnouchi, Hideaki
- Watanabe, Takayuki
- Ohashi, Hiroshi
- Maeda, Hajime
- De Valk, H.W.
- Kooy, Adriaan
- Madziarska, Katarzyna
- Rudofsky, Gottfried
- Malecki, Maciej
- Karpova, Irina
- Zalevskaya, Alsu
- Sardinov, Ruslan
- Schultes, Bernd
- Issa, Basil G.
- Hsia, Stanley
- Jenders, Robert
- Aleppo, Grazia
- Sugimoto, Danny
- Twahirwa, Marcel
- Klonoff, David
- McGill, Janet
- Bredefeld, Cindy
- Donovan, Daniel
- Ipp, Eli
- Bhargava, Anuj
- Bao, Shichun
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2018-07-19
- Volume
- 41
- Issue
- 9
- Pages
- 1938-1946
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2884380775
- Cited by
- 252
- References
- 23
- Citations by year
- 2026: 10 · 2025: 27 · 2024: 19 · 2023: 25 · 2022: 25 · 2021: 27 · 2020: 52 · 2019: 55 · 2018: 11
- FWCI
- 29.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Lirias (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Funders
- AstraZeneca
- Bristol-Myers Squibb
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- dapagliflozin, type 1 diabetes, inadequate glycemic control, SGLT2 inhibitors, insulin dose reduction, HbA1c reduction, weight loss, hypoglycemia, adverse events, glycemic variability, drug safety and efficacy
- MeSH terms
- Adult, Benzhydryl Compounds, Blood Glucose, Body Weight, Diabetes Mellitus, Type 1, Double-Blind Method, Drug Therapy, Combination, Female, Glucosides, Glycated Hemoglobin, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Male, Middle Aged, Diabetic Ketoacidosis, Treatment Outcome
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