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Publications

Journal Article Case Reports Epublish

PubMed: 41424588 DOI: 10.1155/pedi/6859764

The Use of Dapagliflozin in the Treatment of Children With Severe Insulin Resistance.

Pediatr Diabetes 2025:6859764

Authors: Najyya Attia, Khalid Al Noaim, Manal Mustafa, Suliman H Al Fifi, Ibrahim Al Alwan, Nandu Thalange, Amir Babiker

Affiliations

  • College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia, ksau-hs.edu.sa.
  • Division of Pediatric Endocrinology, King Abdullah Specialized Children Hospital, King Abdulaziz Medical City, Jeddah, Saudi Arabia, ngha.med.sa.
  • Research Office, King Abdullah International Medical Research Centre, National Guard Health Affairs, Jeddah, Saudi Arabia, ngha.med.sa.
  • Department of Pediatrics, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia, kfu.edu.sa.
  • Division of Pediatric Endocrinology, Al Jalila Children's Speciality Hospital, Dubai, UAE, aljalilachildrens.ae.
  • Department of Child Health, College of Medicine, King Khalid University, Abha, Saudi Arabia, kku.edu.sa.
  • College of Medicine, King Saud Bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia, ksau-hs.edu.sa.
  • Division of Pediatric Endocrinology, King Abdullah Specialized Children Hospital, King Abdulaziz Medical City, Riyadh, Saudi Arabia, ngha.med.sa.
  • Research Office, King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Saudi Arabia, ngha.med.sa.

Abstract

BACKGROUND

Managing severe insulin resistance (IR) is challenging, necessitating a multifaceted approach, including dietary restriction, exercise, and pharmacotherapy. This paper will detail our utilization of dapagliflozin in a series of cases involving patients with severe IR of various etiology and inadequate glycemic control.

CASE STUDIES

We describe six cases of extreme IR with distinct clinical diagnoses: four with Rabson-Mendenhall syndrome (RMS), one with IR type 1A, and a patient with type 1 diabetes mellitus (T1DM) and severe subcutaneous (SC) IR. These cases exhibit the observable characteristics of IR, characterized by an inability to effectively manage blood glucose (BG) with a standard treatment plan. Every case had a remarkable response to dapagliflozin. Subsequent assessment demonstrated improved HgbA1C, fasting glucose, insulin, and C-peptide concentrations. Furthermore, several cases demonstrated improvement in the clinical manifestations of IR following the administration of dapagliflozin, while others showed a reduction in the frequency of diabetic ketoacidosis (DKA). There were no documented adverse reactions with the use of dapagliflozin for a duration of 2-4 years in these patients.

CONCLUSION

Dapagliflozin appeared both safe and effective as a standalone treatment or when used alongside other antidiabetes medications such as insulin in a case series of children with T1DM and severe IR or IR syndromes (IRS).

MeSH

Diabetes Mellitus, Insulin Resistance, Insulin, Therapeutics, Diabetic Ketoacidosis, Diabetes Mellitus, Type 1, Child