EASD 2019 — Dapagliflozin + insulin beats insulin alone for glycemic control in T1D


  • Brandon May
  • Conference Reports
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Takeaway

  • Adding dapagliflozin (DAPA) to insulin was associated with better glycemic control and greater reductions in body weight compared with placebo in patients with inadequately controlled type 1 diabetes (T1D).

Why this matters

  • Less than one-third of patients with T1D have disease that is optimally controlled.

Study design

  • 28-week extension of the DEPICT-2 study, which initially randomly assigned 815 patients with T1D to either DAPA or placebo.
  • Approximately 83% of the initially randomly assigned patients enrolled and completed the extension phase.
  • Reductions in HbA1c and body weight were assessed at 52 weeks.
  • Adverse events were also assessed at 52 weeks to determine safety.
  • Funding: AstraZeneca.

Key results

  • At 52 weeks, DAPA was associated with reductions in HbA1c with the 5 mg (difference vs placebo: −0.20%; 95% CI, −0.34% to −0.06%) and 10 mg (difference vs placebo: −0.25%; 95% CI, −0.38% to −0.11%) doses.
  • Noticeable reductions in body weight were also observed with the 5 mg DAPA (−4.42%; 95% CI, −5.19% to −3.64%) and 10 mg DAPA (−4.86%; 95% CI, −5.63% to −4.08%) doses.
  • Rates of definite diabetic ketoacidosis were higher in the DAPA-treated groups with 5 mg (4.3%) and 10 mg (3.7%) compared with placebo (0.4%).

Limitations

  • The lack of a “protocol-mandated insulin titration algorithm” that matches real-world clinical practice.