scholarly journals Association of British Clinical Diabetologists (ABCD) position statement on the use of sodium-glucose cotransporter-2 inhibitors in type 1 diabetes (updated 2019)

2019 ◽  
Vol 19 (1) ◽  
pp. 66-72 ◽  
Author(s):  
Umesh Dashora ◽  
Dipesh C Patel ◽  
Robert Gregory ◽  
Peter Winocour ◽  
Ketan Dhatariya ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Position Statement ◽  
Excessive Alcohol Consumption ◽  
Low Calorie Diet ◽  
Sodium Glucose Cotransporter ◽  
Calorie Diet ◽  
Added Benefit ◽  
Excessive Alcohol

SGLT-2 inhibitors may be increasingly used in people with type 1 diabetes as new licenses are obtained. These drugs have the potential to improve glycaemic control in people with type 1 diabetes with the added benefit of weight loss, better control of blood pressure and more time in optimal glucose range. SGLT-2 inhibitors are associated with higher incidence of diabetic ketoacidosis without significant hyperglycaemia. The present ABCD position statement is to mitigate this risk and other potential complications in people taking these drugs. Particular caution needs to be exercised in people who are at risk of diabetic ketoacidosis due to low calorie diet, illnesses, injuries, starvation, excessive exercise, excessive alcohol consumption and reduced insulin administration among other precipitating factors for diabetic ketoacidosis.

scholarly journals Association of British Clinical Diabetologists (ABCD) and Diabetes UK joint position statement and recommendations on the use of sodium-glucose co-transporter inhibitors with insulin for treatment of type 1 diabetes (updated October 2020)

2020 ◽  
Vol 20 (2) ◽  
pp. 155-162
Author(s):  
Umesh Dashora ◽  
Dipesh C Patel ◽  
Robert Gregory ◽  
Peter Winocour ◽  
Ketan Dhatariya ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Position Statement ◽  
Precipitating Factors ◽  
Excessive Alcohol Consumption ◽  
Excessive Exercise ◽  
Added Benefit ◽  
Excessive Alcohol ◽  
The Uk

Dapagliflozin (sodium-glucose co-transporter (SGLT-2) inhibitor) and sotagliflozin (SGLT-1/2 inhibitor) are two of the drugs of the SGLT inhibitor class which have been recommended by the National Institute for Health and Care Excellence (NICE) in people with type 1 diabetes with body mass index ≥27 kg/m2. Dapagliflozin is licensed in the UK for use in the NHS while sotagliflozin may be available in future. These and possibly other SGLT inhibitors may be increasingly used in people with type 1 diabetes as new licences are obtained. These drugs have the potential to improve glycaemic control in people with type 1 diabetes with the added benefit of weight loss, better control of blood pressure and more time in optimal glucose range. However, SGLT inhibitors are associated with a higher incidence of diabetic ketoacidosis without significant hyperglycaemia. The present ABCD/Diabetes UK joint updated position statement is to guide people with type 1 diabetes and clinicians using these drugs to help mitigate this risk and other potential complications. Particularly, caution needs to be exercised in people who are at risk of diabetic ketoacidosis due to low calorie diets, illnesses, injuries, starvation, excessive exercise, excessive alcohol consumption and reduced insulin administration, among other precipitating factors for diabetic ketoacidosis.

scholarly journals Association of British Clinical Diabetologists (ABCD) position statement on the use of sodium-glucose cotransporter-2 (SGLT-2) inhibitors in type 1 diabetes

2018 ◽  
Vol 18 (3) ◽  
pp. 117-121 ◽  
Author(s):  
Umesh Dashora ◽  
Dipesh Patel ◽  
Rob Gregory ◽  
Dinesh Nagi
Keyword(s):  
Type 1 Diabetes ◽  
Glycaemic Control ◽  
Vascular Disease ◽  
Diabetic Ketoacidosis ◽  
Insulin Treatment ◽  
Position Statement ◽  
Treatment Monitoring ◽  
Peripheral Vascular ◽  
Sodium Glucose Cotransporter

SGLT-2 inhibitors are currently neither licensed nor recommended in people with type 1 diabetes. The management of type 1 diabetes consists essentially of insulin treatment, monitoring and education. SGLT-2 inhibitors can be a useful adjunct to insulin treatment in improving glycaemic control. They may also potentially be helpful in reducing cardiovascular and renal complications in people with type 1 diabetes. However, further studies will be needed to establish this. SGLT-2 inhibitors can cause diabetic ketoacidosis and certain circumstances appear to increase this risk. They should therefore be used with caution all the time and only under specialist supervision. Higher amputation rates have been reported with some SGLT-2 inhibitors and hence they should be used with caution in patients with peripheral vascular disease.

scholarly journals Erratum. Use of Sodium–Glucose Cotransporter 2 Inhibitors in Patients With Type 1 Diabetes and Rates of Diabetic Ketoacidosis. Diabetes Care 2020;43:90–97

Diabetes Care ◽  
2020 ◽  
Vol 43 (9) ◽  
pp. 2324-2324
Author(s):  
Christian Hampp ◽  
Richard S. Swain ◽  
Casie Horgan ◽  
Elizabeth Dee ◽  
Yandong Qiang ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Diabetes Care ◽  
Sodium Glucose Cotransporter

scholarly journals Comparison of Protocols to Reduce Diabetic Ketoacidosis in Patients With Type 1 Diabetes Prescribed a Sodium–Glucose Cotransporter 2 Inhibitor

2020 ◽  
pp. ds200038
Author(s):  
Rhea Teng ◽  
Martin Kurian ◽  
Kelly L. Close ◽  
John B. Buse ◽  
Anne L. Peters ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Sodium Glucose Cotransporter

scholarly journals A Systematic Review and Meta-Analysis of Randomised Controlled Trials, Contrasting the Safety Profile between Sodium-Glucose Cotransporter-2 Inhibitors and Placebo in Type 1 Diabetes Mellitus Patients

2019 ◽  
Vol 25 (3-4) ◽  
pp. 62-73 ◽  
Author(s):  
Sumanta Saha ◽  
Sujata Saha
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Genital Infection ◽  
Adult Type ◽  
Sodium Glucose Cotransporter

<b><i>Background:</i></b> This study aims to contrast the side effects of treatment with sodium-glucose cotransporter-2 inhibitors (SGLT2i) and placebo in insulin-treated adult type 1 diabetes mellitus (T1DM) patients. <b><i>Methods:</i></b> Double-blinded randomized controlled trials that compare the above outcome were searched in electronic databases. Next, the risk of bias in eligible studies was assessed, and comparable outcomes were compared by a random-effects meta-analysis. <b><i>Results:</i></b> Seven eligible papers comprising about 3,900 participants were studied. All trials suffered from an unclear risk of detection bias and performance bias. In comparison with the placebo group, the risk of genital infection (RR = 3.22, <i>p</i> &#x3c; 0.001, 95% CI 2.31–4.49, <i>I</i><sup>2</sup> = 0%) and diabetic ketoacidosis (RR = 2.66, <i>p</i> = 0.002, 95% CI 1.45–4.89, <i>I</i><sup>2</sup> = 0%) was higher in the SGLT2i-treated group. <b><i>Conclusion:</i></b> SGLT2i treatment increased the risk of genital infection and diabetic ketoacidosis in adult insulin-treated T1DM patients.

Sign in / Sign up

Export Citation Format

Share Document