Type 1 diabetes mellitus (T1DM) prevalence is increasing and despite all available modern treatment options, an overall small but noticeable increase of mean HbA1c was recently observed in various registries. Authorized adjunctive pharmacological treatment options to insulin therapy are still scarce for T1DM. In February 2019, the European Medicines Agency (EMA) approved dapagliflozin as first in class sodium/glucose co-transporter 2 inhibitor (SGLT-2i) adjunctive therapy to insulin in patients with T1DM, which is currently still not approved by the FDA in the United States. SGLT-2is have shown significant improvement in HbA1c, reducing body weight and increasing time-in-range by reducing glycaemic variability, as well as reductions in total daily insulin dose in the trials in persons with T1DM. The cases presented here translate some of the observations gained from clinical trials into a real-world environment. They demonstrate that even highly practised and educated patients can benefit from the addition of a SGLT-2i as adjunctive treatment to insulin in T1DM. In summary, these cases demonstrate that a variety of patients with T1DM in a real-world setting may benefit from SGLT-2i treatment, as they have the potential to improve HbA1c, excess of body weight and increasing TiR among other things.

中文翻译：

---

在1型糖尿病中辅助使用SGLT-2抑制剂的两个临床案例。

1型糖尿病（T1DM）患病率呈上升趋势，尽管有所有可用的现代治疗方法，但最近在各个登记处均观察到HbA1c总体总体呈小幅上升，但显着上升。对于T1DM而言，胰岛素治疗的授权辅助药理治疗方法仍然很少。2019年2月，欧洲药物管理局（EMA）批准dapagliflozin作为T1DM患者胰岛素辅助钠盐/葡萄糖共转运蛋白2抑制剂（SGLT-2i）的辅助疗法，目前尚无FDA批准。美国。在T1DM患者的试验中，SGLT-2已显示出HbA1c的显着改善，可通过降低血糖变异性来减轻体重和延长射程时间，并减少每日总胰岛素剂量。这里介绍的案例将从临床试验中获得的一些观察结果转化为现实环境。他们证明，即使是训练有素的患者，也可以从SGLT-2i作为T1DM中胰岛素的辅助治疗中受益。总之，这些案例表明，在现实世界中，各种T1DM患者可能会受益于SGLT-2i治疗，因为他们具有改善HbA1c，减轻体重和增加TiR的潜力。