Combination Therapy Enhances Health Outcomes for Adolescents with Type 1 Diabetes

A recent clinical study has revealed promising results for adolescents suffering from type 1 diabetes (T1D) through a combination therapy involving traditional insulin treatment and the investigational drug dapagliflozin. The trial, led by Dr. Farid Mahmud, an endocrinologist at The Hospital for Sick Children (SickKids) and an associate professor at the University of Toronto’s Temerty Faculty of Medicine, assessed 98 participants aged between 12 to 18. The findings, published in *Nature Medicine* on July 24, 2025, indicate that this combination therapy not only improves blood sugar control but also enhances kidney function and mitigates weight gain, common side effects associated with insulin therapy.

Type 1 diabetes is a chronic autoimmune disorder that inhibits the pancreas from producing insulin, critically affecting blood sugar regulation. While traditionally diagnosed in children and young adults, the disease often necessitates lifelong insulin therapy, which can lead to complications such as chronic kidney disease and obesity. Dr. Mahmud emphasized that the research specifically targets the adolescent demographic, which is frequently underrepresented in clinical trials. He noted, "Our findings showed that adolescents who received this combination therapy were able to improve many symptoms typically associated with insulin-managed type one diabetes. This could inform a new early intervention strategy for the growing population of teenagers with type one diabetes.”

The study’s design included participants who received either dapagliflozin or a placebo alongside their standard insulin regimen. Results demonstrated that those on the combination therapy experienced significant health improvements. This is particularly relevant as adolescents face unique challenges in managing their diabetes due to hormonal changes and the transition to greater independence in their treatment protocols.

Lynne McArthur, a patient partner involved in the study, shared her personal journey with T1D and underscored the importance of patient-centric research. Her twin sons were diagnosed with T1D at a young age, propelling her into advocacy and research. "Deciding to participate in a clinical trial is an important decision, but my goal has always been disease prevention. I knew that our participation could help build a future where children don’t get T1D,” McArthur stated. Her ongoing role as a patient advisor ensures that the research remains attuned to the practical experiences of individuals living with diabetes.

The outcomes of this trial lay a foundation for future investigations into precision medicine tailored for young individuals with T1D. One such initiative, the Empowering Diverse Youth with Diabetes Through Precision Medicine (EVERYONE) study, aims to delve deeper into how various personal characteristics—including genetics, metabolism, and social health—affect treatment responses. This aligns with SickKids’s Precision Child Health movement, which advocates for individualized care strategies.

Dr. Mahmud remarked, "This is opening exciting new treatment opportunities for youth with type one diabetes. We’re giving them options that are grounded in science and designed to help them thrive throughout their lives.”

The study received funding from Breakthrough T1D (formerly Juvenile Diabetes Research Foundation, JDRF) and the Canadian Institutes of Health Research Strategies for Patient-Oriented Research, reflecting a commitment to advancing diabetes care.

As the prevalence of type 1 diabetes in adolescents continues to rise, such innovative approaches may significantly alter the management landscape for this vulnerable population, ultimately aiming to reduce the long-term complications associated with the disease.