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In This Issue of Diabetes Care

A pooled analysis of continuous glucose monitoring (CGM) data from the Dapaglifl ozin Evaluation in Patients with Inadequately Controlled Type 1 Diabetes (DEPICT-1 and DEPICT-2) trials suggests that dapaglifl ozin can reduce glucose and glycemic variability in patients with type 1 diabetes. According to Mathieu et al. (p. 1081), the effect was achieved without increasing readings in the range that would indicate hypoglycemia. As a result, they suggest that treatment with the drug on top of adjustable insulin might improve treatment adherence and reduce risk of complications, while noting that concerns in relation to diabetic ketoacidosis remain. The conclusions come from a post hoc analysis of the DEPICT trials and specifi cally the CGM data that was collected at various time points during the two studies. Both trials were phase 3, double blind, placebo controlled, ran for 24 weeks, and included ~800 participants with type 1 diabetes. After pooling the data from both studies, the authors report that both dapaglifl ozin dosing groups (either 5 mg or 10 mg) spent more time in the target glucose range over 24 h compared with placebo. Increases from baseline in terms of time spent in the target range was from ~6.5% and ~9.0% while placebo was reduced by ~2.6%. In terms of hypoglycemia, there were no differences between either dose of the drug and placebo in terms of time spent below 3.9 or 3.0 mmol/L. Additionally, both doses of dapaglifl ozin resulted in reductions in HbA1c of just under 0.5%. Author Chantal Mathieu told Diabetes Care: “What was interesting to see when doing this analysis was the consistent effect throughout the two studies on variability of glucose values, as expressed by a reduction in MAGE (mean amplitude of glycemic excursion), but we were particularly impressed by the substantial increase in time in range. Adding dapaglifl ozin 5 mg or 10 mg to intensive insulin therapy in people living with type 1 diabetes increased the daily time in range by 2 h and 2.3 h compared with a decrease of 0.2 h in the placebo-treated people.” Consensus Report on Diabetic Ketoacidosis and Adjunctive SGLT Inhibitor Therapy in Type 1 Diabetes