En tablett, som sänker blodsocker och ges till patienter med typ 2-diabetes, kan även skydda njuren vid typ 1-diabetes. Det visar en ny studie publicerad i Lancet.
– Detta kan bli stort och göra att många ändrar behandlingen. Njursvikt är ett stort problem och orsakar både lidande och stora kostnader, säger Johan Jendle, professor vid Örebro universitet.
An oral drug can protect kidneys with type 1 diabetes
A glucose lowering drug commonly used in patients with type 2 diabetes, can protect the kidneys in patients with type 1 diabetes. According to results shown in a new study published in the Lancet.
“This can be huge and cause many to switch treatments. Chronic kidney failure is a major problem, leading to both suffering and high costs,” says Johan Jendle, professor at Örebro University.
Johan Jendle standing in a hallway at Campus in Örebro University, professor of medical science
A glucose lowering drug for oral administration and commonly used in patients with type 2 diabetes, can protect the kidneys in patients with type 1 diabetes. According to results shown in a new study published in the Lancet.
“This can be huge and cause many to switch treatments. Kidney failure is a major problem, causes both suffering and high costs,” says Johan Jendle, professor at Örebro University.
Link to article in The Lancet Diabetes & Endocrinology
“But further studies are needed to confirm these findings,” adds Johan Jendle.
Dapagliflozin has shown to protect the kidneys in patients with type 2 diabetes and researchers want to find out if it has the same effect in subjects with type 1 diabetes.
The study included two hundred fifty-one patients with type 1 diabetes and with increased levels of protein in the urine. The patients were divided into three groups: one group received a placebo, another received a low dose of the drug, 5 mg, and the third received a slightly higher dose, 10 mg, of dapagliflozin.Researchers then compared the protein levels in the patients’ urine.
“We examined the kidneys’ ability to filter. High blood sugar and high blood pressure make the kidney vulnerable and unable to cope. I usually compare with a coffee filter that breaks – the grounds then pass through into the coffee. We don’t want the protein to pass through into the urine,” explains Johan Jendle.
In the group receiving the lower dose, protein levels in the urine decreased by 13% and on the higher dose 31% respectively.
“In addition, secondary effects were low,” says Johan Jendle.
A serious side effect of the class of drugs to which dapagliflozin belongs to is an elevated risk of increased ketone bodies, in the blood. Ketones are a sign of acute insulin deficiency and can lead to ketoacidosis. None of the patients in the placebo group developed this condition. Of the patients taking a low dose of dapagliflozin, one per cent were found to have ketones in their blood while four per cent in the group receiving the higher dose.
In the study, three per cent in the placebo group, and five respective six per cent receiving low or high dose of dapagliflozin developed a common genital infection. Researchers also saw an increase in urinary tract infections in patients taking the drug.
“These side-effects are in line with what has previously been reported in patients with type 2 diabetes. And even if the numbers are low, the aim is to use a dose as low as possible to avoid possible side effects. For the first time we have a study that indicates that adjunctive therapy to insulin is associated with a reduced risk of kidney complications," says Johan Jendle.
Since kidney protection was not a pre-specified endpoint in the study but based on previously collected data, the next step is to conduct a so-called prospective randomized clinical trial to confirm the results.
In type 1 diabetes, the body is unable to produce insulin, leading to too much glucose in the blood. Although type 1 diabetes is a life-long disease, effective treatment is available.
In type 2 diabetes, the body has difficulty keeping the blood sugar levels normal. Common symptoms include fatigue and increased urine volumes. Symptoms often develop slowly and can sometimes be difficult to observe. You can act by lifestyle changes to lower your glucose levels, but you will need glucose lowering medication.
Chronic kidney disease can affect almost every part of your body. Potential complications may include: Fluid retention, which could lead to swelling in your arms and legs and accumulation of toxic substances.
Text Linda Harradine
Press release Örebro Universitet
- et al.
www red DiabetologNytt