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Addition of Farxiga to insulin, liraglutide improves glycemia in type 1 diabetes
ORLANDO, Fla. — Patients with type 1 diabetes treated with insulin and liraglutide with the addition of Farxiga have significantly improvements in glycemia.
Farxiga (dapagliflozin, Astra Zeneca) is an SGLT2 inhibitor that blocks the reabsorption of glucose by the kidney, increases glucose excretion and lowers blood glucose levels.
Paresh Dandona, MD, distinguished professor and chief of endocrinology in the department of medicine at the University of Buffalo, and colleagues evaluated 26 adults (mean age, 54 years) with type 1 diabetes for at least 1 year who were receiving insulin and liraglutide therapy for at least 6 months. The patients were randomly assigned to placebo (n = 9) or dapagliflozin 10 mg (n = 17) daily for 12 weeks. For 1 week, dapagliflozin was started at 5 mg daily and then increased to 10 mg daily. Mean HbA1c was 7.68%, average weekly glucose levels were 163 mg/dL and total insulin dose was 53.3 units.
Paresh Dandona
There were no changes in HbA1c level in the placebo group whereas it decreased by 0.6% in the dapagliflozin group (P < .01 vs. placebo). Similarly, there were no changes in average weekly glucose concentrations among controls compared with a 15 mg/dL decrease in the dapagliflozin group (P < .05 vs. baseline; P = .07 vs. placebo). There was no additional hypoglycemia in the dapagliflozin group compared with placebo (P = .52). There was a decrease of 0.72 units in basal insulin dose in the dapagliflozin group (P < .01 vs. baseline) compared with an increase of 1.9 units in the placebo group (P < .05). Total insulin dose did not change in either of the groups.
The placebo group had no change in body weight whereas it decreased by 1.9 kg in the dapagliflozin group (P < .05). Total cholesterol increased by 6% and LDL cholesterol by 8% in the dapagliflozin group whereas total cholesterol decreased by 11% and LDL cholesterol by 17% in the placebo group (P < .05 for both vs. baseline).
“Care has to be exercised in terms of the reduction in the insulin dose and increasing dapagliflozin dose to prevent the occurrence of [diabetic ketoacidosis],” the researchers wrote. “Addition of dapagliflozin to insulin and liraglutide in patients with [type 1 diabetes] results in significant improvement in hypoglycemia.” – by Amber Cox
Reference:
Kuhadiya N, et al. Abstract 213. Presented at: AACE Annual Scientific and Clinical Congress; May 25-29, 2016; Orlando, Fla.
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