Evidence mapPaperPMID 40083075Full record

Trial reportDiabetes, obesity & metabolism2025

Effect of dapagliflozin on blood and breath ketones during supervised insulin withdrawal in adults with type 1 diabetes: A randomized crossover trial.

Max C Petersen, Kai E Jones, Alexander M Markov, Maamoun Salam, Petra Krutilova, Alexis M McKee, Kathryn L Bohnert, Samantha E Adamson, Janet B McGill

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Diabetes, obesity & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Max C PetersenDivision of Endocrinology, Metabolism, & Lipid Research, Washington University School of Medicine, St. Louis, Missouri, USA.ORCID https://orcid.org/0000-0001-8646-2377
Kai E JonesDivision of Endocrinology, Metabolism, & Lipid Research, Washington University School of Medicine, St. Louis, Missouri, USA.
Alexander M MarkovDivision of Endocrinology, Metabolism, & Lipid Research, Washington University School of Medicine, St. Louis, Missouri, USA.
Maamoun SalamDivision of Endocrinology, Metabolism, & Lipid Research, Washington University School of Medicine, St. Louis, Missouri, USA.
Petra KrutilovaDivision of Endocrinology, Metabolism, & Lipid Research, Washington University School of Medicine, St. Louis, Missouri, USA.
Alexis M McKeeDivision of Endocrinology, Metabolism, & Lipid Research, Washington University School of Medicine, St. Louis, Missouri, USA.
Kathryn L BohnertDivision of Endocrinology, Metabolism, & Lipid Research, Washington University School of Medicine, St. Louis, Missouri, USA.
Samantha E AdamsonDivision of Endocrinology, Metabolism, & Lipid Research, Washington University School of Medicine, St. Louis, Missouri, USA.
Janet B McGillDivision of Endocrinology, Metabolism, & Lipid Research, Washington University School of Medicine, St. Louis, Missouri, USA.

Funding

Washington University Institute of Clinical and Translational SciencesUL1TR002345 · WASHINGTON UNIVERSITY · 2025 to 2025
$9.3M
WU P&FP30DK020579 · NIDDK · WASHINGTON UNIVERSITY · 2022 to 2025
$5.6M
Diabetes-Docs: Physician-Scientist Career Development Program (DiabDocs)K12DK133995 · STANFORD UNIVERSITY · 2025 to 2025
$3.7M
DIABETES &RELATED METABOLIC DISEASEST32DK007120 · WASHINGTON UNIVERSITY · 1986 to 2025
$3.4M
Washington University Institute of Clinical and Translational Sciences (KL2)KL2TR002346 · WASHINGTON UNIVERSITY · 2025 to 2025
$1.4M
Calcium-mediated paracrine signaling in beta cell ciliaK08DK142012 · WASHINGTON UNIVERSITY · 2025 to 2025
$153k
JDRF 2-SRA-2022_1190-M-B/P22-03211NCATS NIH HHS KL2 TR002346NCATS NIH HHS UL1 TR002345NIDDK NIH HHS K08 DK142012NIDDK NIH HHS K12 DK133995NIDDK NIH HHS P30 DK020579NIDDK NIH HHS T32 DK007120NIH HHS K12DK133995NIH HHS KL2TR002346NIH HHS P30DK020579NIH HHS T32DK007120NIH HHS UL1TR002345
6 · The paper itself

Abstract

aimsSodium-glucose cotransporter 2 (SGLT2) inhibitors increase ketoacidosis risk, limiting their use in type 1 diabetes. To better understand the pathophysiology of SGLT2 inhibitor-mediated ketoacidosis, we measured blood glucose, capillary blood and plasma β-hydroxybutyrate (BOHB) and breath acetone (BrACE) during supervised insulin withdrawal in adults with type 1 diabetes with and without dapagliflozin treatment. MATERIALS AND

methodsTwenty adults with type 1 diabetes underwent supervised insulin withdrawal twice in a randomized crossover design: during usual care and after treatment with dapagliflozin (10 mg daily for 2 weeks plus the test day). After insulin withdrawal, capillary blood glucose, BOHB and BrACE measurements were obtained at least hourly until stopping rules were met (>8 h elapsed, symptoms of ketosis, glucose >400 mg/dL, BOHB >4 mmol/L or participant request).

resultsThe peak BOHB and BrACE values achieved during supervised insulin withdrawal were both greater with dapagliflozin than with usual care. Throughout the insulin withdrawal study, dapagliflozin treatment was associated with significantly greater BOHB and BrACE concentrations. The proportions of participants reaching BOHB >1.5 mmol/L and >2.5 mmol/L during supervised insulin withdrawal were greater in the dapagliflozin arm. Blood glucose reached a lower peak in the dapagliflozin arm.

conclusionsIn adults with type 1 diabetes undergoing supervised insulin withdrawal, dapagliflozin treatment compared to usual care was associated with greater blood and breath ketone concentrations in the absence of significant hyperglycaemia.

Indexed as

Benzhydryl CompoundsDiabetes Mellitus, Type 1Diabetic KetoacidosisGlucosidesHypoglycemic AgentsKetonesSodium-Glucose Transporter 2 Inhibitors3-Hydroxybutyric AcidAcetoneAdultBlood GlucoseBreath TestsCross-Over StudiesFemaleHumansInsulin3-Hydroxybutyric AcidAcetoneBenzhydryl CompoundsBlood GlucosedapagliflozinGlucosidesHypoglycemic AgentsInsulinKetonesSodium-Glucose Transporter 2 Inhibitorsblood ketonesbreath acetoneclinical trialketoacidosisSGLT2 inhibitortype 1 diabetes

Identifiers

PMID40083075
PMCPMC12049266

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.