Dapagliflozin use in type 1 diabetes: industry, business and ethics


  • Sufyan Hussain Imperial College London
  • Hilary Nathan Juvenile Diabetes Research Foundation UK, London
  • Susannah Rowles Department of Diabetes, Pennine Acute Hospitals NHS Trust, UK




type 1 diabetes, sodium glucose co-transporter-2 (SGLT-2) inhibitors, dapagliflozin


We provide a summary on the unprecedented withdrawal of dapagliflozin’s license in Type 1 diabetes by AstraZeneca. We also provide a summary from a national survey of 52 sites in the United Kingdom, with 70% respondents reporting clinically significant benefits following dapagliflozin use in type 1 diabetes. We describe some of the challenges faced by clinicians supporting people with type 1 diabetes using dapagliflozin. This withdrawal, which was solely for commercial reasons and not due to adverse safety events, raises important considerations about ethics and transparency required from the pharmaceutical industry. It also strongly highlights the need for consultation from key stakeholders including clinicians and patient groups prior to such decisions.


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