PMID- 37241059
OWN - NLM
STAT- MEDLINE
DCOM- 20230529
LR  - 20230530
IS  - 1648-9144 (Electronic)
IS  - 1010-660X (Print)
IS  - 1010-660X (Linking)
VI  - 59
IP  - 5
DP  - 2023 Apr 24
TI  - Benefit or Risk in Patient with Type 1 Diabetes Based on Appropriated Dosage of 
      Dapagliflozin: A Case Report.
LID - 10.3390/medicina59050827 [doi]
LID - 827
AB  - Purpose: Dapagliflozin has been used extensively in patients with type 2 diabetes 
      mellitus (T2DM). However, due to the potential diabetic ketoacidosis (DKA) risk 
      of dapagliflozin, its use in type 1 diabetes mellitus (T1DM) is limited. Here, we 
      reported an obese patient with T1DM and inadequate glycemic control. We carefully 
      recommended she use dapagliflozin as an insulin adjuvant to achieve better 
      glycemia control and to assess possible benefits and risks. Methods and Results: 
      The patient was a 27-year-old female who had underlying T1DM for 17 years with a 
      body weight of 75.0 kg, body mass index (BMI) of 28.2 kg/m(2), and glycated 
      hemoglobin (HbA1c) 7.7% when admitted. To treat her diabetes, she had used an 
      insulin pump for 15 years (the recent dosage of insulin was 45 IU/d) and oral 
      metformin for 3 years (0.5 g qid). In order to decrease body weight and achieve 
      better glycemic control, dapagliflozin (FORXIGA, AstraZeneca, Indiana) was 
      administered as an insulin adjuvant. The patient presented sever DKA with a 
      euglycemia (euDKA) after two days of the administration of dapagliflozin at a 
      dose of 10 mg/d. euDKA occurred again after the administration of dapagliflozin 
      at a dose of 3.3 mg/d. However, after using a smaller dose of dapagliflozin (1.5 
      mg/d), this patient achieved better glycemia control, with a significant 
      reduction in daily insulin dosage and gradual weight loss, without significant 
      hypoglycemia or DKA occurring. At the sixth month of the administration of 
      dapagliflozin, the HbA1c was 6.2% for the patient, her daily insulin dosage was 
      22.5 IU, and her body weight was 60.2 kg. Conclusions: The appropriate dose of 
      dapagliflozin is critical for a patient with T1DM patient therapy in order to 
      find a correct balance between the benefits and risks.
FAU - Tian, Yan
AU  - Tian Y
AUID- ORCID: 0000-0002-5927-4706
AD  - Department of Endocrinology, Shanghai East Hospital, School of Medicine, Tongji 
      University, Shanghai 200120, China.
FAU - Hu, Weiting
AU  - Hu W
AD  - Department of Endocrinology, The Second Hospital of Shanxi Medical University, 
      Shanxi Medical University, Taiyuan 030002, China.
FAU - Yan, Qun
AU  - Yan Q
AD  - Department of Endocrinology, Shanghai East Hospital, School of Medicine, Tongji 
      University, Shanghai 200120, China.
FAU - Feng, Bo
AU  - Feng B
AD  - Department of Endocrinology, Shanghai East Hospital, School of Medicine, Tongji 
      University, Shanghai 200120, China.
LA  - eng
GR  - 81870529/National Natural Science Foundation/
PT  - Case Reports
DEP - 20230424
PL  - Switzerland
TA  - Medicina (Kaunas)
JT  - Medicina (Kaunas, Lithuania)
JID - 9425208
RN  - 1ULL0QJ8UC (dapagliflozin)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Glycated Hemoglobin)
RN  - 0 (Blood Glucose)
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
RN  - 0 (Insulin)
SB  - IM
MH  - Humans
MH  - Female
MH  - Adult
MH  - *Diabetes Mellitus, Type 1/complications/drug therapy
MH  - *Diabetes Mellitus, Type 2/complications/drug therapy
MH  - Hypoglycemic Agents/therapeutic use
MH  - Glycated Hemoglobin
MH  - Blood Glucose
MH  - *Sodium-Glucose Transporter 2 Inhibitors/therapeutic use
MH  - Insulin/therapeutic use
MH  - *Diabetic Ketoacidosis/drug therapy
MH  - Body Weight
PMC - PMC10223692
OTO - NOTNLM
OT  - DKA
OT  - Dapagliflozin
OT  - SGLT2 inhibitors
OT  - T1DM
COIS- The authors declare no conflict of interest.
EDAT- 2023/05/27 09:42
MHDA- 2023/05/29 06:41
PMCR- 2023/04/24
CRDT- 2023/05/27 01:20
PHST- 2023/03/01 00:00 [received]
PHST- 2023/04/18 00:00 [revised]
PHST- 2023/04/21 00:00 [accepted]
PHST- 2023/05/29 06:41 [medline]
PHST- 2023/05/27 09:42 [pubmed]
PHST- 2023/05/27 01:20 [entrez]
PHST- 2023/04/24 00:00 [pmc-release]
AID - medicina59050827 [pii]
AID - medicina-59-00827 [pii]
AID - 10.3390/medicina59050827 [doi]
PST - epublish
SO  - Medicina (Kaunas). 2023 Apr 24;59(5):827. doi: 10.3390/medicina59050827.