Evidence mapPaperPMID 40629004Full record

Trial reportDiabetologia2025

Dapagliflozin's impact on hormonal regulation and ketogenesis in type 1 diabetes: a randomised controlled crossover trial.

Andreas Gübeli, Nicole Steiner, Andreas Limacher, Déborah Mathis, Andreas Melmer, Markus Laimer

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Diabetologia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04035031 (Effects of SGLT-2 Inhibitor Dapagliflozin on Hormonal Glucose Regulation and Ketogenesis in Patients With Type 1 Diabetes - a Randomised, Placebo-controlled, Open-label, Cross-over Intervention Study), which is not on this 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.

NCT04035031 phase3completednot on this map

Effects of SGLT-2 Inhibitor Dapagliflozin on Hormonal Glucose Regulation and Ketogenesis in Patients With Type 1 Diabetes - a Randomised, Placebo-controlled, Open-label, Cross-over Intervention Study

TypeinterventionalSponsorInsel Gruppe AG, University Hospital BernRan2020 to 2020Enrolled13ConditionsDiabetes Mellitus, Type 1ArmsForxiga 10mg, Placebo
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

6 authors.

Andreas GübeliDepartment of Diabetes, Endocrinology, Clinical Nutrition & Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.ORCID http://orcid.org/0009-0006-2530-8388
Nicole SteinerDepartment of Diabetes, Endocrinology, Clinical Nutrition & Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Andreas LimacherDepartment of Clinical Research, University of Bern, Bern, Switzerland.ORCID http://orcid.org/0000-0002-9094-9476
Déborah MathisUniversity Institute of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.ORCID http://orcid.org/0000-0002-2326-7782
Andreas MelmerDepartment of Diabetes, Endocrinology, Clinical Nutrition & Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.ORCID http://orcid.org/0000-0001-8085-8768
Markus LaimerDepartment of Diabetes, Endocrinology, Clinical Nutrition & Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Markus.Laimer@insel.ch.ORCID http://orcid.org/0000-0002-7622-0822

Funding

Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung 32003B_185019
6 · The paper itself

Abstract

aims/hypothesisThis study aimed to assess the impact of adding dapagliflozin to insulin therapy on key hormonal determinants of glucose regulation and ketogenesis. We hypothesise that dapagliflozin increases glucagon-like peptide 1 (GLP-1), glucagon and ketone body concentrations, based on the results of a pilot study.

methodsThe study was designed as a randomised, placebo-controlled, open-label, crossover intervention study with two periods (dapagliflozin and placebo intake), including patients of the Department of Diabetes, Endocrinology, Clinical Nutrition & Metabolism, Inselspital, Bern University Hospital, University of Bern. Individuals with type 1 diabetes (C-peptide concentrations <0.1 nmol/l) with a duration >5 years and a BMI of 20-29 kg/m

resultsA total of 13 individuals with type 1 diabetes were included and randomised. All of them received dapagliflozin and placebo, finished the sequences per protocol and were analysed per protocol. GLP-1 concentrations did not differ significantly between treatments in the OGTTC (median [IQR] dapagliflozin 192.8 [129.8-257.2] pmol/l vs placebo 176.3 [138.4-227.4] pmol/l; p=0.7) or HEC (median [IQR] dapagliflozin 208.6 [133.6-294.0] pmol/l vs placebo 203.1 [150.2-291.8] pmol/l; p=0.7). Glucagon concentrations did not significantly differ between treatments in the OGTTC (median [IQR] dapagliflozin 1.54 [0.84-3.68] ng/l vs placebo 1.54 [0.82-4.64] ng/l; p=0.8) or HEC (median [IQR] dapagliflozin 1.59 [0.87-3.54] ng/l vs placebo 1.63 [0.91-3.96] ng/l; p=0.3). Somatostatin concentrations remained comparable between treatments during the HEC (median [IQR] dapagliflozin 41.1 [26.8-73.8] pmol/l vs placebo 47.0 [23.0-77.6] pmol/l; p=0.2) and OGTTC (median [IQR] dapagliflozin 51.1 [31.1-77.0] pmol/l vs placebo 45.3 [30.0-70.5] pmol/l; p=0.2). Plasma ketone bodies were higher with dapagliflozin during the HEC (median [IQR] dapagliflozin 0.15 [0.04-0.47] mmol/l vs placebo 0.03 [0.01-0.12] mmol/l; p<0.001) and OGTTC (median [IQR] dapagliflozin 0.10 [0.03-0.22] mmol/l vs placebo 0.03 [0.01-0.12] mmol/l; p<0.001). CONCLUSIONS/

interpretationShort-term dapagliflozin treatment in type 1 diabetes increases plasma ketone concentrations without affecting the secretion of GLP-1, glucagon or somatostatin. Higher ketone body concentrations highlight the elevated risk of diabetic ketoacidosis associated with the adjunct intake of dapagliflozin.

trial registrationClinicalTrials.gov NCT04035031.

fundingSwiss National Science Foundation, project number 32003B_185019.

Indexed as

Benzhydryl CompoundsDiabetes Mellitus, Type 1GlucosidesAdultBlood GlucoseC-PeptideCross-Over StudiesFemaleGlucagonGlucagon-Like Peptide 1HumansHypoglycemic AgentsInsulinKetone BodiesMaleMiddle AgedBenzhydryl CompoundsBlood GlucoseC-PeptidedapagliflozinGlucagonGlucagon-Like Peptide 1GlucosidesHypoglycemic AgentsInsulinKetone BodiesSodium-Glucose Transporter 2 InhibitorsDapagliflozinDiabetic ketoacidosisGLP-1GlucagonKetogenesisSomatostatinType 1 diabetes

Identifiers

PMID40629004
PMCPMC12423202

What Socratic holds

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Registered trials

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.