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Add‐on therapy with dapagliflozin under full closed loop control improves time in range in adolescents and young adults with type 1 diabetes: The DAPADream study

Diabetes, Obesity and Metabolism Dec 16, 2020

Biester T, Muller I, von dem Berge T, et al. - This study was undertaken to explore the impact of the sodium‐glucose co‐transporter‐2 inhibitor dapagliflozin on glucose levels overnight and during the following day after two unannounced meals under full closed-loop (FCL) conditions. Researchers studied non‐obese persons with type 1 diabetes (T1D) twice (10 mg dapagliflozin bid vs. placebo) for 24 hours with two unannounced mixed meal tests 6 hours apart under FCL conditions for this single-centre, double‐blind, randomized, placebo‐controlled, cross‐over trial. The sensor glucose time in range (TIR; 3.9‐10 mmol/L) was the primary outcome. They assessed ß‐hydroxybutyrate, glucagon, insulin, and gastric inhibitory polypeptide for safety evaluation. The trial included 15 adolescents (aged 15.4 ± 1.6 years, diabetes duration 10.0 ± 3.4 years, HbA1c 8.4% ± 0.9% [67.7 ± 10.1 mmol/mol]) and 15 young adults (aged 18.7 ± 0.8 years; diabetes duration 12.5 ± 3.6 years; HbA1c 8.3% ± 0.9% [68.5 ± 11.2 mmol/mol]). The outcomes of this study exhibited that dapagliflozin significantly increased time in range on average by 259 minutes/day while reducing glycaemic variability during FCL control without any signs of hypoglycemia or ketosis in adolescents and adults with T1D.

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