{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T06:29:40Z","timestamp":1793255380947,"version":"4.5.0"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":353,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Diabetes"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Studies<\/jats:title>\n                    <jats:p>We describe six cases of extreme IR with distinct clinical diagnoses: four with Rabson\u2013Mendenhall 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\u2010peptide 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\u20134 years in these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/pedi\/6859764","type":"journal-article","created":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T10:10:04Z","timestamp":1766225404000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Use of Dapagliflozin in the Treatment of Children With Severe Insulin Resistance"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9418-2321","authenticated-orcid":false,"given":"Najyya","family":"Attia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5469-1220","authenticated-orcid":false,"given":"Khalid","family":"Al Noaim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8821-0066","authenticated-orcid":false,"given":"Manal","family":"Mustafa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4062-3378","authenticated-orcid":false,"given":"Suliman H.","family":"Al Fifi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8982-6348","authenticated-orcid":false,"given":"Ibrahim","family":"Al Alwan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7925-625X","authenticated-orcid":false,"given":"Nandu","family":"Thalange","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7538-852X","authenticated-orcid":false,"given":"Amir","family":"Babiker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,20]]},"reference":[{"key":"e_1_2_10_1_2","doi-asserted-by":"publisher","DOI":"10.1038\/nm.4350"},{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.83.9.5143"},{"key":"e_1_2_10_3_2","first-page":"193","volume-title":"Advances in Endocrinology and Metabolism","author":"Mantzoros C. S.","year":"1995"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.13171"},{"key":"e_1_2_10_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199109263251307"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.13667"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.49.4.626"},{"key":"e_1_2_10_8_2","first-page":"177","article-title":"Somatomedin-C\/IGF-1 Measured by Radioimmunoassay and Somatomedin Bioactivity in Adolescents With Insulin Dependent Diabetes Compared With Puberty Matched Controls","volume":"9","author":"Taylor A. M.","year":"1988","journal-title":"Diabetes Research (Edinburgh, Scotland)"},{"key":"e_1_2_10_9_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-71-5-1356"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.2001.00898.x"},{"key":"e_1_2_10_11_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc05-1249"},{"key":"e_1_2_10_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/dom.12638"},{"key":"e_1_2_10_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.12825"},{"key":"e_1_2_10_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/2042018814560735"},{"key":"e_1_2_10_15_2","first-page":"247","volume-title":"Androgen Excess Disorders in Women","author":"Mantzoros C. S.","year":"1997"},{"key":"e_1_2_10_16_2","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M110.118620"},{"key":"e_1_2_10_17_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.83.2.4602"},{"key":"e_1_2_10_18_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI70704"},{"key":"e_1_2_10_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2008.01789.x"},{"key":"e_1_2_10_20_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1149239"},{"key":"e_1_2_10_21_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-89752-w"},{"key":"e_1_2_10_22_2","unstructured":"European Medicines Agency Assessment Report: Forxiga (Dapagliflozin). Procedure No. EMEA\/H\/C\/002322 2012 European Medicines Agency Accessed on 1 April 2013https:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/EPARPublic_assessment_report\/human\/002322\/WC500136024.pdf."},{"key":"e_1_2_10_23_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-159-4-201308200-00007"},{"key":"e_1_2_10_24_2","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5359.13906"},{"key":"e_1_2_10_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-007-0600-5"},{"key":"e_1_2_10_26_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-0606"},{"key":"e_1_2_10_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.13266"},{"key":"e_1_2_10_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.13667"},{"key":"e_1_2_10_29_2","doi-asserted-by":"crossref","unstructured":"AgarwalS. GuptaM. andGunnS. Use of Inhaled Insulin in a Patient With Subcutaneous Insulin Resistance Syndrome: A Rare Condition AACE Clinical Case Reports 2019 5 no. 3 e187\u2013e191 https:\/\/pubmed.ncbi.nlm.nih.gov\/31967031\/.","DOI":"10.4158\/ACCR-2018-0493"},{"key":"e_1_2_10_30_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26125669"},{"key":"e_1_2_10_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(24)00127-X"},{"key":"e_1_2_10_32_2","doi-asserted-by":"publisher","DOI":"10.5812\/ijem-126350"},{"key":"e_1_2_10_33_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-0078"},{"key":"e_1_2_10_34_2","doi-asserted-by":"publisher","DOI":"10.2337\/diab.46.2.271"},{"key":"e_1_2_10_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(17)30308-X"},{"key":"e_1_2_10_36_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-0623"},{"key":"e_1_2_10_37_2","article-title":"Dapagliflozin No Longer Licensed for Type 1 Diabetes","volume":"11","author":"DTB Team","year":"2022","journal-title":"Drug and Therapeutics Bulletin"},{"key":"e_1_2_10_38_2","unstructured":"Dapagliflozin With Insulin for Treating Type 1 Diabetes 2021 NICE Retrieved 13 March 2021https:\/\/www.nice.org.uk\/guidance\/ta597\/chapter\/1-Recommendations."},{"key":"e_1_2_10_39_2","doi-asserted-by":"publisher","DOI":"10.1159\/000527653"},{"key":"e_1_2_10_40_2","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14060"},{"key":"e_1_2_10_41_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2013.356"},{"key":"e_1_2_10_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.04.051"},{"key":"e_1_2_10_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2021.12.019"},{"key":"e_1_2_10_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2025.133384"},{"key":"e_1_2_10_45_2","doi-asserted-by":"publisher","DOI":"10.1159\/000539300"},{"key":"e_1_2_10_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(22)00052-3"},{"key":"e_1_2_10_47_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-024-06481-8"},{"key":"e_1_2_10_48_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021-055671"},{"key":"e_1_2_10_49_2","doi-asserted-by":"publisher","DOI":"10.3389\/fgene.2024.1414451"},{"key":"e_1_2_10_50_2","doi-asserted-by":"publisher","DOI":"10.3390\/molecules30153112"}],"container-title":["Pediatric Diabetes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/pedi\/6859764","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/pedi\/6859764","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/pedi\/6859764","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T08:11:16Z","timestamp":1772957476000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/pedi\/6859764"}},"subtitle":[],"editor":[{"given":"Tomoyuki","family":"Kawamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":50,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1155\/pedi\/6859764"],"URL":"https:\/\/doi.org\/10.1155\/pedi\/6859764","archive":["Portico"],"relation":{},"ISSN":["1399-543X","1399-5448"],"issn-type":[{"value":"1399-543X","type":"print"},{"value":"1399-5448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2025-01-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"6859764"}}