DIABETES and obesity continue to be leading global health concerns, with research continually investigating new and effective treatments. A recent study has assessed the effectiveness of combined dapagliflozin and moderate calorie restriction on remission for adults diagnosed with Type 2 diabetes in the last 6 years. Researchers observed a 16% increase in the remission rate for those treated with dapagliflozin and moderate calorie restriction, compared with moderate calorie restriction alone.
The multi-centre, double blind, randomised, placebo controlled trial analysed data from 328 participants from 16 centres in China from June 2020–January 2023, who were aged 20–70 years, with BMI over 25, and only taking metformin as diabetes treatment at screening. Participants were split into dapagliflozin and placebo groups (165 and 163 participants), continuing interventions for 12 months, unless remission occurred. The dapagliflozin group underwent moderate calorie restriction (500–750 kcal reduction) combined with 10 mg daily dapagliflozin. The placebo group had restricted calorie intake alone. Participants had dietary counselling, maintained food logs, and were encouraged to stay active throughout the study (brisk walking for 150 minutes per week or 10,000 steps daily).
Relative risk for remission (defined by glycated haemoglobin [HbA1c] <6.5% and fasting plasma glucose <126 mg/dL in the absence of all diabetic drugs for at least 2 months) was 1.56 (95% CI: 1.17–2.09) (44% [73/165] for the dapagliflozin group and 28% [46/163] for the placebo group). Furthermore, relative risk increased to 1.64 (95% CI: 1.14–2.37) after 3 months diabetes drug absence and 1.74 (95% CI: 1.18–2.56) after 4 months. Additionally, the study found significant differences in metabolic risk factors between groups. Notably, the dapagliflozin group showed greater reduction in body mass and increased insulin sensitivity.
The findings of this study suggest daily dapagliflozin and moderate calorie reduction increases remission rate for people with recently diagnosed Type 2 diabetes, compared to calorie reduction alone. However, the authors note some limitations in their study, for example, their results may not apply to those who have had diabetes for over 6 years, or people of different ethnicities. Further research could investigate the effects of dapagliflozin and moderate calorie restriction in those with longer term (diagnosed over 6 years ago) Type 2 diabetes or the continued effects of a dapagliflozin and moderate calorie restriction regime following remission.
Reference
Yuejun, L et al. Dapagliflozin plus calorie restriction for remission of type 2 diabetes: multicentre, double blind, randomised, placebo controlled trial. BMJ. 2025;DOI:10.1136/bmj-2024-081820
