Using Dapagliflozin for Diabetes Remission

Created/Updated: #jan2025

Associated notes: Diabetes Remission

Summary of the Article

1. Title of the Article

Dapagliflozin plus calorie restriction for remission of type 2 diabetes: multicentre, double-blind, randomised, placebo-controlled trial

2. First Two Authors Followed by et al.

Yuejun Liu, Ying Chen, et al.

3. One-line Summary of the Article

A combination of dapagliflozin and calorie restriction significantly increases the rate of type 2 diabetes remission compared to calorie restriction alone in overweight or obese patients.

4. Six Key Points from the Article

  1. Study Design & Participants – A multicentre, double-blind, placebo-controlled trial conducted in China with 328 overweight or obese patients (BMI >25) with type 2 diabetes of less than 6 years’ duration.

  2. Intervention & Outcome – Participants followed a calorie-restricted diet (500-750 kcal deficit per day) and received either dapagliflozin (10 mg/day) or a placebo for 12 months. The primary outcome was diabetes remission, defined as HbA1c <6.5% and fasting plasma glucose <126 mg/dL without antidiabetic medication for at least 2 months.

  3. Primary Findings – Diabetes remission was achieved in 44% of patients in the dapagliflozin group vs. 28% in the placebo group (Risk Ratio: 1.56, 95% CI: 1.17-2.09, p=0.002).

  4. Weight & Metabolic Improvements – The dapagliflozin group had greater weight loss (−5.0 kg vs. −3.2 kg, p<0.001), improved insulin resistance (HOMA-IR: −0.8, p<0.001), and better metabolic parameters including blood pressure, triglycerides, and HDL cholesterol.

  5. Safety & Adverse Events – No significant differences in adverse event rates between the groups; urinary tract infections were slightly higher in the dapagliflozin group but no severe complications were reported.

  6. Clinical Implications – This study suggests a feasible pharmacological approach to achieving diabetes remission using a combination of SGLT-2 inhibitors and moderate calorie restriction, which may be more practical than very low-calorie diets or bariatric surgery.

5. Practical Take-Home Message

For overweight or obese patients with early type 2 diabetes, a regimen of dapagliflozin combined with a moderate calorie deficit significantly increases the likelihood of diabetes remission. This strategy provides a viable, non-invasive alternative to intensive calorie restriction or bariatric surgery.

6. Citation for the Article in Vancouver Format

Liu Y, Chen Y, Ma J, Lin J, Liu C, Li X, et al. Dapagliflozin plus calorie restriction for remission of type 2 diabetes: multicentre, double-blind, randomised, placebo-controlled trial. BMJ. 2025;388:e081820. doi:10.1136/bmj-2024-081820.