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Dapagliflozin: An effective adjunctive treatment in type 1 diabetes

Many people with type 1 diabetes continue to have high HbA1c levels despite insulin therapy, with an associated elevated risk of cardiovascular events and increased mortality. Adjunctive prescription of a sodium–glucose cotransporter 2 (SGLT2) inhibitor in type 1 diabetes has been approved as a potential intervention. In this case series, the authors report the outcomes of six adults with type 1 diabetes who initiated on dapagliflozin in East Cheshire. Over a 6-month period, mean HbA1c fell from 78.5 mmol/mol (9.3%) to 55 mmol/mol (7.2%). Analysis of flash glucose monitoring data showed that the proportion of readings in the target range (4–10 mmol/L) increased from 33.1% to 65.2% following addition of dapagliflozin, while the proportion of readings above target (>10 mmol/L) decreased from 68.0% to 26.4%. Dapagliflozin was well tolerated and improved glycaemic control with no increase in hypoglycaemia rates.

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