Pioneering Study on the Triple Therapy Treatment in Type 1 Diabetes

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Improvements in the delivery of insulin through insulin pumps, novel preparations of insulin analogs and the introduction of continuous glucose monitoring have been beneficial for people with type 1 diabetes but an overwhelming majority are still not well controlled.

Drugs like liraglutide (Victoza) and dapagliflozin (Forxiga) as adjunct therapy with insulin in type 1 diabetes can improve control, and dapagliflozin has very recently been approved for this indication in Europe. However, neither drug alone gets the majority of people with type 1 diabetes to the recommended target: an HbA1c below 7%.  

Dr Paresh Dandona, Distinguished Professor at State University of New York, and Professor John Petrie, Professor of Diabetic Medicine at the University of Glasgow, both global leaders in the treatment of type 1 diabetes, have now been generously funded ($1.6M) by the JDRF, the leading global organization funding type 1 diabetes research, to address this gap.  The TTT-1 clinical trial will assess combination therapy with insulin, dapagliflozin and semaglutide (Ozempic) in adults with type 1 diabetes. Semaglutide is from the same class as liraglutide but is far more potent, only requiring weekly injections. We hypothesize that combination therapy will reduce HbA1c to less than 7% in the majority of people with type 1 diabetes.

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The first participant in the TTT-1 trial, described by JDRF as the single most advanced drug-based study to date in type 1 diabetes, was randomized in July 2019. Glasgow co-applicants include Dr James Boyle, Dr Robbie Lindsay and Professor Ian Ford.  Dr Joe Timmons has been recruited to work on the trial as a Clinical Research Fellow.

Since dapagliflozin and semaglutide have cardiovascular benefits and can also induce weight loss, there may be additional advantages of this drug combination. In addition, both dapagliflozin and semaglutide are likely to reduce unpredictable fluctuations in blood glucose levels and thus provide a greater sense of security to patients and improve quality of life.

First published: 29 July 2019