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The TTT1 trial will assess a new combination therapy with insulin, balancing the effects of dapagliflozin and semaglutide.
The trial will begin in Scotland in early 2020 and aims to help the overwhelming number of individuals with the condition for whom blood glucose is still not controlled to target levels, despite improvements in technology including insulin pumps and continuous glucose monitoring.
The trial is led by the University of Glasgow’s global leader in the treatment of type 1 diabetes, Dr John Petrie, Professor of Diabetic Medicine. It aims to address a gap in current diabetes treatment, which sees a majority of people on insulin therapy with HbA1c above the recommended target of 7%, indicating high blood glucose over the previous two to three months.
Dapagliflozin (Forxiga), as well as a drug related to semaglutide called liraglutide (Victoza), can improve control in adults with type 1 diabetes. Dapagliflozin has recently been approved for this purpose in the UK and Europe; however, neither drug alone consistently gets most people with type 1 diabetes to the recommended target HbA1c.
Professor Petrie said: “The hope is to use the combination therapy of dapagliflozin and semaglutide to reduce HbA1c to less than 7% in the majority of people with type 1 diabetes; and since these drugs have benefits for the heart and can also induce weight loss, there may be additional advantages of this drug combination, which would be very positive for those with the condition.
“In addition, both dapagliflozin and semaglutide are likely to reduce unpredictable fluctuations in blood glucose levels, thus providing a greater sense of security for people with type 1 diabetes, substantially improving quality of life.”
Rachel Connor, Director of Research Partnerships at JDRF, said: “Type 1 diabetes is a really challenging condition to manage, and the limitations of the tools we have today, both technologies and medicines, mean that many people living with the condition struggle to achieve the glucose management targets recommended by doctors.
“We’re proud to support the TTT1 trial and are hopeful that this will lead to a new way to help people with type 1 reduce HbA1c and so also reduce their risk of developing long term complications.”