Dapagliflozin linked to lower blood sugar but increased DKA in type 1 diabetes

Jack Woodfield
Tue, 31 Jul 2018
Dapagliflozin linked to lower blood sugar but increased DKA in type 1 diabetes
A drug used to treat type 2 diabetes has been found to improve blood sugar levels but is linked to a higher risk of diabetic ketoacidosis (DKA) in those with type 1 diabetes, according to research.

Dapagliflozin (Forxiga) is an SGLT2 inhibitor drug which helps the kidneys remove glucose from the blood and pass it out through the person's urine. The way the drugs works helps to lower blood sugar levels and aids weight loss.

While insulin is a necessary treatment for people with type 1 diabetes, researchers are investigating additional medications to improve blood glucose control.

The 24-week trial involved 813 people with type 1 diabetes who had HbA1c levels of at least 58.5 mmol/mol (7.5%).

A total of 271 participants received a small daily dose (5mg) of the dapagliflozin, while 270 was administered a larger dose (10mg) and the remaining 272 took a placebo.

The findings suggested those who took the smaller dose of Forxiga saw their HbA1c levels reduce on average by 0.37% and the group who were given the larger dose saw their levels drop by 0.4%. There was also a reduction in the amount of insulin needed in the two groups who were given the drug.

However, there were also side effects which saw some people report genital infections and increased episodes of DKA. DKA affected 2.2% of the 10mg dose participants, 2.6% of the 5mg group, and 0% of those taking placebo.

DKA is a serious condition that can be life-threatening, therefore more understanding will be needed in future trials to prevent DKA from developing.

Dr Chantal Mathieu, from the Catholic University of Leuven in Belgium, said: "Introduction of dapagliflozin as an adjunct therapy could be an interesting and exciting new treatment for type 1 diabetes, almost 100 years after the discovery of life-saving insulin.

"However, adding dapagliflozin to the insulin regimen needs to be balanced against the increased risk of diabetic ketoacidosis, and this therapy should be coupled with intensive educational measures to cope with the small, but real risks."

There are now plans to further extend the study to continue researching how safe and effective dapagliflozin is over a longer period of time.

The results have been published online in Diabetes Care.
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