Real world outcomes of adjunctive sodium-glucose cotransporter-2 (SGLT2) inhibitors in adults with type 1 diabetes: a single-centre retrospective analysis

Mariateresa Cascio; Nicholas Cron; Younes Younes Ramazan; Kavitha Lakshmipathy; Despoina Tseke; Benjamin Field; Vidhu Nayaar; James Clark; Sunil Zachariah; Julian Emmanuel

doi:10.1530/endoabs.117.P111

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Endocrine Abstracts (2026) 117 P111 | DOI: 10.1530/endoabs.117.P111

SFEBES2026 Poster Presentations Metabolism, Obesity and Diabetes (68 abstracts)

Real world outcomes of adjunctive sodium-glucose cotransporter-2 (SGLT2) inhibitors in adults with type 1 diabetes: a single-centre retrospective analysis

Mariateresa Cascio ¹ , Nicholas Cron ² , Younes Ramazan Younes ¹ , Kavitha Lakshmipathy ¹ , Despoina Tseke ¹ , Benjamin Field ¹ , Vidhu Nayaar ¹ , James Clark ¹ , Sunil Zachariah ¹ & Julian Emmanuel ¹

Author affiliations

¹Surrey and Sussex Healthcare NHS Trust, Redhill, Surrey, United Kingdom; ²London School of Economics, London, United Kingdom

Background: SGLT-2 inhibitors improve weight and glycaemic control in type 1 diabetics, (1,2) however concerns remain regarding increased diabetic ketoacidosis (DKA) risk. This study aims to evaluate their efficacy and safety as adjuncts to insulin in adults with type 1 diabetes.

Methods: We conducted a retrospective review of adults (≥18 years) with type 1 diabetes prescribed adjuvant SGLT-2 inhibitors at a single centre between February 2018 and September 2021. Clinical data including HbA1c, body weight, and total daily insulin dose were collected before and after SGLT-2 initiation. Paired t-tests were used for statistical analysis.

Results: Eleven patients were included (seven women, mean age 50.3 ± 15 years), diabetes duration 29.6 ± 12.2 years. Duration of adjunctive SGLT-2 was 24.8 ± 11.6 months. Five patients were on 5 mg dapagliflozin, four on 10 mg and two on 25 mg empagliflozin. Mean HbA1c decreased from 74 ± 21.7 to 65.3 ± 15.2 mmol/mol (P = 0.08). Weight decreased from 83.8 ± 22.7 kg to 82.7 ± 25.9 kg (P = 0.3), and insulin dose reduced from 48.1 ± 14.6 to 46.5 ± 11.8 units/day (P = 0.6). One case of thrush (9%) and one DKA (9%) occurred; the latter in a patient not following sick day rules. No urinary tract infections or severe hypoglycaemia were reported.

Conclusion: In this cohort, adjunctive SGLT-2 therapy was well tolerated, improving HbA1c, weight and insulin dose - though not statistically significant, likely due to small sample size. Despite proven benefits, withdrawal of their license in type 1 diabetes limits access to a valuable therapeutic option.

References: 1. Dandona P, et al. (2018). Efficacy and Safety of Dapagliflozin in Patients with Inadequately Controlled Type 1 Diabetes: The DEPICT-1 52-Week Study. Diabetes Care, 41(12), 2552-2559. 2. Rosenstock J, et al. (2018). Empagliflozin as Adjunctive to Insulin Therapy in Type 1 Diabetes: The EASE Trials. Diabetes Care, 41(12), 2560-2569.