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 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 Glycosylated Hemoglobin Levels and Lipid Profile in Type 1 Diabetes Mellitus and Precipitating Factorsin Diabetic Ketoacidosis

2020 ◽  
Vol 8 (1) ◽  
pp. 47-51
Author(s):  
Chilumula Monica ◽  
Saleem
Keyword(s):  
Diabetes Mellitus ◽  
Urinary Tract Infection ◽  
Type 1 Diabetes ◽  
Urinary Tract ◽  
Type 1 Diabetes Mellitus ◽  
Lipid Profile ◽  
Diabetic Ketoacidosis ◽  
Glycosylated Hemoglobin ◽  
Precipitating Factors

Background: Type-1 Diabetes Mellitus is the most common endocrine-metabolic disorder of childhood and adolescence. The diseases has a prevalence of approximately 1 in 2500 children at age 5 years to approximately 1 in 300 children by age 18 years. A recent study from Madras suggests that diabetes in Indian children is present in a frequency of 10.5 per 1,00,000 patient years. Prevalence of childhood diabetes among urban population in India is 0.26 per 1000. Type-1 diabetes constituted nearly 90 to 100% of all children with diabetes. Objective: The objectives of this research were to study the levels of glycosylated hemoglobin and lipid profile in type 1 diabetes mellitus in children attending Gandhi Hospital Secunderabad, Telangana and to study the precipitating factors in Diabetic Ketoacidosis (DKA). Subjects and Methods:Design: This was a Cross-Sectional study. Duration: One year and six months i.e. from January 2017 to June 2018. Participants: 50 diabetic children of age less than 18 years attending Gandhi Hospital, Secunderabad, Telangana were included in the study.The diabetic cases were studied using a predesigned and pretested proforma. A detailed clinical examination was carried out with detailed anthropometric measurements and necessary lab investigations were done. Metabolic profile was assessed by investigating for blood sugar levels, glycosylated hemoglobin, and lipid profile. Rates, ratios and percentages of presentations and significance were calculated using Chi-square test.Result:48 % cases had onset of diabetes Mellitus at 13-18 years with Male: female ratio of 1.27: 1. 20 % had family history of diabetes. 16 % children had normal nutrition, 20 % children had grade I and grade II, 38% had grade III and 6 % children had grade IV. 54% children had glycosylated hemoglobin level of more than 10% indicating poor glycemic control, 32 % had fair control, and 14 % had good glycosylated hemoglobin levels. 62 % presented with fever , 40 % presented with symptoms of polyuria, polydipsia and polyphagia, 37.5 % presented with vomiting, 18 % children with loose stools, abdominal pain, 20 % children had breathlessness, 6% presented with seizures. 88.9% were diagnosed to have diabetic ketoacidosis as their initial presentation of diabetes mellitus Causes for precipitating factors of diabetic ketoacidosis were associated infections like pneumonia (22 %) and urinary tract infection(16 %), Non availability of insulin doses (25%), non-acceptance by child (16.66 %). Recurrent hospitalization in the patients with 5 years diabetic duration was statistically significant. Common causes being hypoglycemia (38 %) recurrent DKA (24 %), pneumonia (12 %) and urinary tract infections (8 %). 23.52% cases were non-compliant.Conclusion:More than half of the cases(54%) had poor glycemic control. Majority presented with classical symptoms of polyuria, polydipsia, polyphagia, fever, breathlessness and diabetic ketoacidosis as clinical presentation. Causes for precipitating factors of diabetic ketoacidosis were associated infections like pneumonia and urinary tract infection, non-availability of insulin doses and non- acceptance by child.

Identifying targets to reduce the incidence of diabetic ketoacidosis at diagnosis of type 1 diabetes in the UK

2014 ◽  
Vol 99 (5) ◽  
pp. 438-442 ◽  
Author(s):  
K. Lokulo-Sodipe ◽  
R. J. Moon ◽  
J. A. Edge ◽  
J. H. Davies
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
The Uk

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.

Predictors of diabetic ketoacidosis hospitalizations and hemoglobin A1c among youth with Type 1 diabetes.

2019 ◽  
Vol 38 (7) ◽  
pp. 577-585 ◽  
Author(s):  
Katherine Semenkovich ◽  
Kristoffer S. Berlin ◽  
Rachel L. Ankney ◽  
Kimberly L. Klages ◽  
Mary E. Keenan ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Hemoglobin A1c

Causes of diabetic ketoacidosis: type 1 diabetes versus type 2 diabetes

2017 ◽  
Author(s):  
Marwa Omri ◽  
Rayene Ben Mohamed ◽  
Imen Rezgani ◽  
Sana Mhidhi ◽  
Aroua Temessek ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis
Sign in / Sign up

Export Citation Format

Share Document