Short-term effects of dapagliflozin on insulin sensitivity, postprandial glucose excursion and ketogenesis in type 1 diabetes mellitus: A randomized, placebo-controlled, double blind, cross-over pilot study.

Melmer, Andreas; Kempf, Patrick; Lunger, Lukas; Pieber, Thomas R; Mader, Julia K; Stettler, Christoph; Tilg, Herbert; Ebenbichler, Christoph F; Laimer, Markus (2018). Short-term effects of dapagliflozin on insulin sensitivity, postprandial glucose excursion and ketogenesis in type 1 diabetes mellitus: A randomized, placebo-controlled, double blind, cross-over pilot study. Diabetes, obesity & metabolism, 20(11), pp. 2685-2689. Wiley 10.1111/dom.13439

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We investigated the short-term effects of dapagliflozin as adjunct to insulin on insulin sensitivity, postprandial glucose excursions and ketone body production in type 1 diabetes mellitus (T1DM). A total of seven male patients completed the randomized, double-blind, placebo-controlled cross-over trial, receiving 10 mg of dapagliflozin daily for 3 days, followed by placebo, or the reverse. At Day 3, hyperinsulinaemic, euglycaemic clamps and oral glucose tolerance test clamps with repeated blood sampling were performed. Required glucose infusion and blood glucose excursions did not differ significantly between dapagliflozin treatment and placebo (P = 0.491; P = 0.342). Prior to oral glucose, total ketone bodies showed a higher trend following dapagliflozin treatment (P = 0.051). Following oral glucose, total ketone bodies decreased while concentrations of total GLP-1 were higher following dapagliflozin (P = 0.009). Non-esterified free fatty acids did not differ between dapagliflozin treatment and placebo and ketonuria was absent under both conditions. In T1DM, short-term addition of dapagliflozin to insulin influenced neither postprandial glucose excursions nor insulin sensitivity. Following oral glucose, total ketone bodies decreased in parallel with an increase in GLP-1 concentrations, which were higher under dapagliflozin treatment as compared with placebo.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition

UniBE Contributor:

Melmer, Andreas, Kempf, Patrick, Stettler, Christoph, Laimer, Markus

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1463-1326

Publisher:

Wiley

Language:

English

Submitter:

Markus Laimer

Date Deposited:

21 Feb 2019 10:42

Last Modified:

05 Dec 2022 15:25

Publisher DOI:

10.1111/dom.13439

PubMed ID:

29923299

Uncontrolled Keywords:

GLP-1 secretion dapagliflozin euglycaemic DKA glucose clamp hyperinsulinaemic-euglycaemic clamp

BORIS DOI:

10.7892/boris.125376

URI:

https://boris.unibe.ch/id/eprint/125376

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