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Could type 2 diabetes treatments help people with type 1 achieve stronger control?

A new trial is set to test whether a combination of medications for type 2 diabetes could help more people with type 1 diabetes to achieve stronger blood glucose control.

The TTT1 trial is being co-led by the University of Glasgow and the State University of New York. The trial is being funded by type 1 diabetes charity, JDRF, and will get underway in Scotland early next year.

The research trial will assess whether using a combination of dapagliflozin and semaglutide, in addition to insulin, can help a greater number of people with type 1 diabetes to achieve HbA1c results below 53 mmol/mol (7%).

Dapagliflozin and semaglutide are both medications which were developed to treat type 2 diabetes. Dapagliflozin, marketed as Forxiga, is a sodium-glucose transport protein 2 (SGLT2) inhibitor. It works by allowing the kidneys to flush out excess glucose from the blood and excrete it via the urine. Semaglutide, marketed as Ozempic, is a glucagon-like peptide-1 (GLP-1) receptor agonist drug which helps to suppress glucagon release and slow down digestion following meals.

Dr John Petrie, Professor of Diabetic Medicine at the University of Glasgow is leading the trial. Dr Petrie says he hopes that the combination therapy will help the majority of people with type 1 diabetes to achieve an HbA1c level of 53 mmol/mol (7%) or lower.

To date, people with type 1 diabetes in the UK are working hard to achieve good control but most are getting HbA1c results above of 53 mmol/mol (7%).

Dr Petrie adds, “…since these drugs have benefits for the heart and can also induce weight loss, there may be additional advantages of this drug combination, which would be very positive for those with the condition.

“In addition, both dapagliflozin and semaglutide are likely to reduce unpredictable fluctuations in blood glucose levels, thus providing a greater sense of security for people with type 1 diabetes, substantially improving quality of life.”

Rachel Connor, Director of Research Partnerships at JDRF UK, stated how the charity is pleased to be supporting the trial: “We’re proud to support the TTT1 trial and are hopeful that this will lead to a new way to help people with type 1 reduce HbA1c and so also reduce their risk of developing long term complications.”

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