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Home > News & events > News > New trial results show potential protection against kidney damage in young adults
If someone with type 1 diabetes (T1D) has persistent high blood sugar, they can be at risk of several complications later in life. These can include eye damage (retinopathy), nervous system damage (neuropathy), or kidney damage (nephropathy). Complications can, however, present from a younger age than expected in people with T1D.
This trial, called ATTEMPT, was run in Canada and was funded by the Canadian Institutes for Health Research and Breakthrough T1D. It investigated the use of a drug called dapagliflozin on young adults (aged 12-21) with T1D to see if it could improve their kidney function. Dapagliflozin is a sodium-glucose cotransporter-2 (SGLT2) inhibitor, which is an oral medication already approved for type 2 diabetes. It reduces blood glucose levels by stopping the kidneys from absorbing it, instead encouraging glucose to be released in urine.
This drug was taken as an adjunctive therapy, meaning it was taken alongside insulin. Different variables were measured, which included HbA1C, time in range, and kidney function (glomerular filtration rate). This trial is the first of its kind in adolescents, as research is not often carried out on this age group. It is also the first time an SGLT2 inhibitor has been tested to help optimise diabetes control in young adults.
The study showed that a low dose of dapagliflozin improved both kidney function and glycaemic management. Participants’ time in range improved by 9% and HbA1c decreased by 0.47% over the span of 22 weeks. This means dapagliflozin could be used at a low dose to improve kidney function in young adults with T1D.
The study also investigated safety with regards to diabetic ketoacidosis (DKA). DKA is one of the most severe complications of T1D and can lead to emergency hospitalisation and even death. The results were deemed safe in the trial, with no serious adverse events reported. There was one mild case of DKA reported. A DKA Risk Mitigation Strategy was introduced due to the risk of illness to the participants.
In the UK, dapagliflozin is only licenced to be used for type 2 diabetes, heart disease and kidney disease. The results from this Canadian trial could pave the way for further research and longer studies on the potential benefits of using adjunctive therapies such as dapagliflozin to help manage T1D and its long-term complications.
There is currently a trial called SOPHIST which is investigating a SGLT2 inhibitor called sotagliflozin. The trial is investigating if this can improve the quality of life of people with T1D and heart failure, without any safety issues. This clinical trial is funded by Breakthrough T1D UK and is ongoing across Scotland, England and Wales. Find out more about taking part in the SOPHIST trial.
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