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Farxiga improves beta-cell function, insulin resistance in type 2 diabetes
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NASHVILLE, Tenn – The glycemic control medication Farxiga significantly improved both beta-cell function and insulin sensitivity in adults with type 2 diabetes, according to study findings presented here.
Carolina Solis-Herrera, MD, of the University of Texas Health Science Center in San Antonio, TX, said the insulin secretion/insulin resistance index, also known as the disposition index – a marker of beta-cell health – improved by twofold in patients treated with the drug vs. those who received a placebo.
Carolina Solis-Herrera
Farxiga (dapagliflozin, Astra Zeneca) is a sodium-glucose co-transporter 2 (SGLT-2) inhibitor that blocks the reabsorption of glucose by the kidney, increases glucose excretion and lowers blood glucose levels. The FDA approved the drug for use in patients with type 2 diabetes in January 2014.
Solis-Herrera and colleagues analyzed data from 24 adult males from area VA hospitals who had type 2 diabetes. Participants received either 10 mg of dapagliflozin (16) or placebo (8) for 14 days. Researchers administered oral glucose tolerance tests and an euglycemic insulin clamp at baseline as well as after therapy was completed.
Following treatment, oral glucose tolerance tests showed that fasting plasma glucose fell from 177 mg/dl to 147 mg/dl (P = .02), while 2-hour fasting glucose decreased from 330 mg/dl to 264 mg/dl (P < .05).
Solis-Herrera also reported that patients in the study saw a significant improvement in insulin secretion in the dapagliflozin group (1.7 vs. 3.1, P = .03). Beta-cell function was also markedly improved (-0.98 vs. 1.96, P = .02)
Decreased glucotoxicity improving beta-cell function “shows how that is one of the core defects in diabetes,” Solis-Herrera told Endocrine Today. “It also improved insulin sensitivity, insulin secretion, and total body glucose disposal. So, [it’s] definitely a drug that can be used for the treatment of diabetes.
“Possibilities of combinations are very attractive right now, as this drug increased glucagon secretion,” Solis-Herrera said after presenting the findings. “The other thing is that showing that [decreasing] glucotoxicity improves beta cell function underscores the importance of keeping diabetes [patients] at target or below target [blood sugar levels].”
The FDA has warned that dapagliflozin should not be used to treat patients with type 1 diabetes, those who have increased ketones in their blood or urine or those with moderate-to-severe renal impairment.
Solis-Herrera said none of the patients in the study showed signs of diabetic ketoacidosis. – by Regina Schaffer
Reference:
Solis-Herrera, C. “Dapagliflozin improves beta cell function and insulin sensitivity in type 2 diabetes mellitus.” Presented at: AACE 24th Annual Scientific & Clinical Congress; May 13-17, 2014; Nashville, Tenn.
Disclosure: Solis-Herrera reports no relevant financial disclosures.