scholarly journals International Consensus on Risk Management of Diabetic Ketoacidosis in Patients With Type 1 Diabetes Treated With Sodium–Glucose Cotransporter (SGLT) Inhibitors

Diabetes Care ◽  
2019 ◽  
Vol 42 (6) ◽  
pp. 1147-1154 ◽  
Author(s):  
Thomas Danne ◽  
Satish Garg ◽  
Anne L. Peters ◽  
John B. Buse ◽  
Chantal Mathieu ◽  
...  
Keyword(s):  
Risk Management ◽  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
International Consensus ◽  
Sodium Glucose Cotransporter

scholarly journals SGLT inhibitors and euglycaemic diabetic ketoacidosis: earlier observations rediscovered

2019 ◽  
Vol 19 (1) ◽  
pp. 37-41
Author(s):  
Salem A Beshyah ◽  
Brian M Frier
Keyword(s):  
Diabetic Ketoacidosis ◽  
Case Reports ◽  
International Consensus ◽  
Critical Feature ◽  
Metabolic Derangement ◽  
New Class ◽  
Sodium Glucose Cotransporter ◽  
Life Threatening ◽  
Clinical Interest

Diabetic ketoacidosis (DKA) is a life-threatening metabolic derangement, defined by the presence of severe hyperglycaemia, ketosis and metabolic acidosis. Recently, DKA was redefined to be present when the latter two abnormalities occur without severe hyperglycaemia. Munro and colleagues in Edinburgh described ‘euglycaemic diabetic ketoacidosis’ in 1973 and suggested this new terminology. The same year the critical feature of this subclass of DKA – that is, an increased urinary loss of glucose – was identified by Ireland and Thomson in Glasgow. In the subsequent 40 years (from 1974 to 2014), clinical interest in this condition was limited to a few case reports. The emergence of a new class of antidiabetes medications, the sodium-glucose cotransporter (SGLT) inhibitors, which promote profuse glycosuria, has reawakened interest in euglycaemic DKA, as this is a side effect of these drugs. The earlier perceptive observations of these physicians in Scotland deserve to be recognised for their contribution in identifying and describing euglycaemic DKA and correctly identifying its underlying pathogenesis. Recent international consensus has provided guidance to physicians to aid timely recognition of the condition by testing for ketosis in the appropriate clinical context and to manage it effectively by discontinuing the SGLT inhibitor and provision of insulin, carbohydrate and hydration (the STICH protocol). This may be particularly relevant in view of the recent licensing developments for use of certain members of the SGLT inhibitors in type 1 diabetes.

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.

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.

Sign in / Sign up

Export Citation Format

Share Document