SGLT2 inhibitors reduce day-to-day glucose variability in patients with type 1 diabetes.

INTRODUCTION SGLT2 inhibitors (SGLT2i) are used worldwide because of their multiple benefits for patients with type 2 diabetes. The purpose of this study was to determine the efficacy and safety of SGLT2i in patients with type 1 diabetes (T1DM). MATERIALS AND METHODS Patients with T1DM who had been treated with SGLT2i for >12 weeks were included in this retrospective observation study. We recorded the changes in body mass, insulin dose, blood and urine test data, and adverse events. The changes in day-to-day glucose variability, as the primary endpoint, was evaluated using the interquartile range (P25/P75) of the ambulatory glucose data obtained using continuous glucose monitoring (CGM). RESULTS Fifty-one patients (37 women; mean age 52.7 years) were included. HbA1c and body mass significantly decreased by 0.4% and 1.6 kg, respectively. The total required insulin dose decreased by 9.4% (42.7 ± 26.6 to 38.7 ± 24.3 units/day). CGM data were obtained from 30 patients. P25/P75 decreased by 17.6 ± 20.7% during SGLT2i treatment (P<0.001). The percentage of time per day within the target glucose range of 70-180 mg/dL significantly increased (from 42.2% to 55.5%, P<0.001), without an increase in the percentage of time spent in the hypoglycemic range (<70 mg/dL). Urinary ketone bodies were detected in four patients (7.8%), but none developed ketoacidosis. CONCLUSIONS SGLT2i improved day-to-day glucose variability and time in the target glucose range, without increasing frequency of hypoglycemia, in patients with T1DM, and reduced HbA1c, body mass, and the required insulin dose.