SGLT2 reduces required insulin dose in poorly controlled type 2 diabetes
Sodium-glucose cotransporter 2 (SGLT2) administration concurrent with the initiation of intensive insulin therapy appears to reduce the required insulin doses in patients with poorly controlled type 2 diabetes (T2D), a new study has found.
Researchers randomized 18 T2D patients to receive basal/bolus insulin titration algorithm (INS) either alone (n=9; mean age 55±13.3 years) or with dapagliflozin 5 mg/day (INS/DAPA; n=9; mean age 46.3±9.02). The main study outcomes were total daily dose of insulin needed to achieve euglycaemia, and energy expenditure (EE) and respiratory quotient (RQ) during fasting and postprandial states.
All patients in the INS/DAPA group achieved euglycaemia. This was significantly greater than that in the INS alone group (100 percent vs 55.6 percent; p=0.04).
Moreover, between post-treatment days 5 and 7, patients who were coadministered dapagliflozin required significantly lower insulin doses, when measured as total insulin dose (1.48±0.32 vs 1.81±0.38 U/kg; p<0.05) and basal/bolus ratio (0.41±0.96 vs 0.47±0.77; p<0.05).
There were no significant between-group differences in terms of postprandial and fasting EE. The same was true for postprandial RQ, though fasting values were significantly higher in the INS/DAPA group (0.78±0.07 vs 0.72±0.05; p<0.05). Changes in body weight, blood pressure and urinary glucose excretion were comparable between groups.
Both treatments were comparably safe. Treatment-emergent adverse events were reported in one patient (11.1 percent) in each group. Nausea was reported in both patients, while the one belonging to the INS/DAPA group also had decreased appetite.