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UB study offers hope for improved type 1 diabetes treatment

A majority of patients with type 1 diabetes did significantly better at controlling blood sugar when they used insulin and a medicine for type 2 diabetes known as dapagliflozin, a study by University at Buffalo researchers shows.

Called DEPICT-1, the study was the first multicenter investigation of dapagliflozin to test its effectiveness and safety in type 1 diabetes. The results demonstrate that when the drug, a sodium glucose cotransporter-2 inhibitor, was administered in addition to the insulin that patients with type 1 diabetes need to survive, it significantly improved outcomes, the researchers concluded.

“Our paper provides the initial signal that dapagliflozin is safe and effective in patients with type 1 diabetes and is a promising adjunct treatment to insulin to improve glycemic control,” senior author Dr. Paresh Dandona said in a statement.

A potential improvement in treatment is important. For diabetics, especially those with type 1, the risk of eye, kidney, foot and heart problems is increased, and life expectancy is reduced.

The 24-week study, which appears in The Lancet Diabetes and Endocrinology journal, was conducted in 833 patients at 143 sites in 17 countries, including the United States. It was funded by AstraZeneca and Bristol-Myers Squibb, the companies that developed dapagliflozin.

About half of the patients taking dapagliflozin reduced their measure of blood sugar levels by more than 0.5 percent, considered a significant decrease, without experiencing severe drops in blood sugar, or hypoglycemia, according to Dandona, a SUNY distinguished professor, and chief of endocrinology, diabetes and metabolism in the Jacobs School of Medicine and Biomedical Sciences.

Also of significance, the patients did not experience ketoacidosis, a complication that occurs when acids and substances called ketones build up in the blood from lack of insulin.

In a journal commentary, Dr. John R. Petrie of the Institute of Cardiovascular and Medical Sciences in Glasgow, Scotland, noted that larger and longer-term trials of the safety and efficacy of the therapy are needed. However, if ketoacidosis risk can be mitigated, use of dapagliflozin and similar drugs as added treatments to insulin may reduce the burden of complicating conditions, he said.

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