Clinical Trial Shows Combination Therapy May Benefit Teens with Type 1 Diabetes

A clinical trial has found that combining standard insulin therapy with the investigational drug dapagliflozin can improve kidney function, blood sugar control, and reduce weight gain in adolescents with type 1 diabetes (T1D). Published in Nature Medicine, the study points to a promising new direction for precision care in young people living with this chronic condition.

Type 1 diabetes is an autoimmune disorder that causes the pancreas to stop producing insulin, often beginning in childhood or adolescence. While insulin remains essential for treatment, long-term use can lead to complications such as chronic kidney disease and weight gain. This study, known as the ATTEMPT trial, was designed to evaluate whether a combination approach could reduce these risks in teens.

The trial enrolled 98 participants aged 12 to 18 years across three sites, testing the effects of dapagliflozin alongside insulin. Unlike prior research that focused primarily on adults, this trial was tailored to adolescents, who face unique challenges in diabetes management due to hormonal shifts and shared caregiving responsibilities.

“Our findings showed that adolescents who received this combination therapy were able to improve many symptoms typically associated with insulin-managed type one diabetes,” said Dr. Farid Mahmud, Associate Scientist in the Translational Medicine program and Staff Physician in the Division of Endocrinology, at The Hospital for Sick Children (SickKids). “This could inform a new early intervention strategy for the growing population of teenagers with type one diabetes.”

Reference: Mahmud, F.H., Bjornstad, P., Clarson, C. et al. Adjunct-to-insulin therapy using SGLT2 inhibitors in youth with type 1 diabetes: a randomized controlled trial. Nat Med (2025). https://doi.org/10.1038/s41591-025-03723-6