Adjunct-to-insulin therapy using SGLT2 inhibitors in youth with type 1 diabetes: a randomized controlled trial
Primary result · Change in mGFRResult — go to the resultDifference −8.8 ml min-1 1.73 m-2 95% CI −12.7 to −4.8Authors' conclusion
In youth with T1D, dapagliflozin as an adjunct-to-insulin treatment reduced mGFR, improved glycemic control and was safe when combined with ketone testing and risk mitigation strategies.
Study context
- Population
- Youth with T1D, 12–21 years of age, 53% female (ATTEMPT trial)
- Participants
- 98 participants
- Comparison
- Dapagliflozin 5 mg vs placebo, as adjunct to insulin
- Primary endpoint
- Change in measured glomerular filtration rate (mGFR) using iohexol clearance
- Follow-up
- 22 weeks
Methodological detailsdouble-blind, placebo-controlled
- Double-blind
- Placebo-controlled
Primary result
Change in mGFR
Difference
−8.8 ml min-1 1.73 m-2
95% CI −12.7 to −4.8
P < 0.0001
Dapagliflozinvs Placebo
difference −8.8 ml min-1 1.73 m-2 (95% CI −12.7 to −4.8); P < 0.0001
As reported in the abstract
- Higher baseline measured glomerular filtration rate (mGFR) associated with greater attenuation with dapagliflozin (r)
- −0.58; P < 0.0001
Further findings
HbA1c
- HbA1c decreased
- 0.47% (95% CI: −0.66 to −0.28)
TIR (70-180 mg dl-1, 4-10 mmol L-1)
- TIR increased
- 9.0% (95% CI: 3.8-14.3)
Body weight
- Body weight decreased with dapagliflozin
- 2.8 kg (95% CI: −3.7 to −2.0)
Total daily insulin dose (U kg-1)
- No differences observed
Safety
- Mild diabetic ketoacidosis (DKA) in the dapagliflozin group
- 1 case
- Adverse events similar between groups
Original publication
Adjunct-to-insulin therapy using SGLT2 inhibitors in youth with type 1 diabetes: a randomized controlled trial. Nat Med. Published 6 June 2025. doi:10.
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