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Glucose Variables in Type 1 Diabetes Studies With Dapagliflozin: Pooled Analysis of Continuous Glucose Monitoring Data From DEPICT-1 and-2

Artikel i vetenskaplig tidskrift
Författare C. Mathieu
P. Dandona
M. Phillip
T. Oron
Marcus Lind
L. Hansen
F. Thoren
J. Xu
A. M. Langkilde
Depict- Investigators; DEPICT-2 Investigators Depict- Investigators; DEPICT-2 Investigators
Publicerad i Diabetes Care
Volym 42
Nummer/häfte 6
Sidor 1081-1087
ISSN 0149-5992
Publiceringsår 2019
Publicerad vid Institutionen för medicin
Sidor 1081-1087
Språk en
Länkar dx.doi.org/10.2337/dc18-1983
Ämnesord glycemic variability, treatment satisfaction, severe hypoglycemia, sglt2, inhibitor, double-blind, insulin, association, retinopathy, efficacy, outcomes, Endocrinology & Metabolism
Ämneskategorier Endokrinologi och diabetes

Sammanfattning

OBJECTIVEThis pooled analysis assessed continuous glucose monitoring (CGM) in patients with inadequately controlled type 1 diabetes (HbA(1c) >= 7.7 to <= 11.0% [>= 61 to <= 97 mmol/mol]) who received dapagliflozin as an adjunct to adjustable insulin.RESEARCH DESIGN AND METHODSCGM data were pooled from two 24-week, double-blind, randomized, phase 3 studies: Dapagliflozin Evaluation in Patients with Inadequately Controlled Type 1 Diabetes (DEPICT-1 and DEPICT-2). These studies comprised 1,591 patients receiving dapagliflozin 5 mg (n = 530), dapagliflozin 10 mg (n = 529), or placebo (n = 532).RESULTSBaseline characteristics were balanced between treatment groups. Patients receiving dapagliflozin 5 mg or 10 mg both spent more time with blood glucose in the range >3.9 to <= 10.0 mmol/L (>70 to <= 180 mg/dL) over 24 h than those receiving the placebo. The adjusted mean (SE) change from baseline at week 24 was 6.48% (0.60) with dapagliflozin 5 mg, 8.08% (0.60) with dapagliflozin 10 mg, and -2.59% (0.61) with placebo. At week 24, the mean amplitude of glucose excursion over 24 h, mean 24-h glucose values, and postprandial glucose values were also improved in patients receiving dapagliflozin over those receiving placebo. No marked differences were found at week 24 between dapagliflozin 5 or 10 mg and placebo in the percentage of glucose values <= 3.9 mmol/L (<= 70 mg/dL) or <= 3.0 mmol/L (<= 54 mg/dL) over 24 h, or in nocturnal (0000-0559 h) glucose values <= 3.9 mmol/L (<= 70 mg/dL).CONCLUSIONSIn patients with type 1 diabetes, treatment with dapagliflozin over 24 weeks improved time in range, mean glucose, and glycemic variability without increasing the time spent in the range indicating hypoglycemia.

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