scholarly journals Metabolic Effects of an SGLT2 Inhibitor (Dapagliflozin) During a Period of Acute Insulin Withdrawal and Development of Ketoacidosis in People With Type 1 Diabetes

Diabetes Care ◽  
2020 ◽  
Vol 43 (9) ◽  
pp. 2128-2136 ◽  
Author(s):  
Roselle A. Herring ◽  
Fariba Shojaee-Moradie ◽  
Robert Garesse ◽  
Mary Stevenage ◽  
Nicola Jackson ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Sglt2 Inhibitor ◽  
Metabolic Effects ◽  
Insulin Withdrawal

scholarly journals Metabolic effects of an SGLT2 inhibitor (dapagliflozin) during a period of acute insulin withdrawal and development of ketoacidosis in people with type 1 diabetes.

2020 ◽  
Author(s):  
Roselle A Herring ◽  
Fariba Shojaee-Moradie ◽  
Robert Garesse ◽  
Mary Stevenage ◽  
Nicola Jackson ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Pump ◽  
Sglt2 Inhibitor ◽  
Metabolic Effects ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Double Blind ◽  
Peripheral Tissues ◽  
Insulin Withdrawal

Objective: To determine the effect of SGLT<sub>2</sub> inhibitor dapagliflozin on glucose flux, lipolysis and ketone body concentrations during insulin withdrawal in people with type 1 diabetes. <p> </p> <p>Research Design and Methods: A double-blind placebo controlled crossover study with a 4-week wash out period was performed in 12 people with type 1 diabetes using insulin pump therapy. Participants received dapagliflozin or placebo in random order for 7 days. Stable isotopes were infused to measure the rate of glucose production (Ra), disappearance (Rd) and lipolysis. At isotopic steady state insulin was withdrawn and the study terminated after 600 minutes or earlier if blood glucose reached 18mmol/L, bicarbonate <15mmol/L, venous pH <7.35 or capillary ketones >5.0 mmol/L. </p> <p><br></p><p>Results: At baseline, glucose Ra was significantly higher with dapagliflozin than placebo. Following insulin withdrawal, plasma glucose concentrations at the end point were significantly lower with dapagliflozin than placebo and AUC<sub>0-180min </sub>glucose Rd and AUC<sub>0-180min </sub>β-hydroxybutyrate (BOHB) were significantly higher. There was a small but significantly higher AUC<sub>0-180min </sub>glycerol Ra (measure of lipolysis) with dapagliflozin. Non-esterified fatty acid concentrations were not different between treatments.</p> <p>When divided by BMI>27 and <27kg/m<sup>2</sup>, basal glucose Ra and BOHB, and AUC<sub>0-180min </sub>glycerol Ra were significantly higher in the low BMI group with dapaglifozin versus placebo treatment.</p> <p><br></p><p>Conclusions: During insulin withdrawal the increase in BOHB with dapaglifozin may be partially due to increased lipolysis. However reduced renal excretion, reduced BOHB uptake by peripheral tissues or a metabolic switch to increase ketogenesis within the liver may also play a role. <u></u></p>

scholarly journals Metabolic effects of an SGLT2 inhibitor (dapagliflozin) during a period of acute insulin withdrawal and development of ketoacidosis in people with type 1 diabetes.

2020 ◽  
Author(s):  
Roselle A Herring ◽  
Fariba Shojaee-Moradie ◽  
Robert Garesse ◽  
Mary Stevenage ◽  
Nicola Jackson ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Pump ◽  
Sglt2 Inhibitor ◽  
Metabolic Effects ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Double Blind ◽  
Peripheral Tissues ◽  
Insulin Withdrawal

Objective: To determine the effect of SGLT<sub>2</sub> inhibitor dapagliflozin on glucose flux, lipolysis and ketone body concentrations during insulin withdrawal in people with type 1 diabetes. <p> </p> <p>Research Design and Methods: A double-blind placebo controlled crossover study with a 4-week wash out period was performed in 12 people with type 1 diabetes using insulin pump therapy. Participants received dapagliflozin or placebo in random order for 7 days. Stable isotopes were infused to measure the rate of glucose production (Ra), disappearance (Rd) and lipolysis. At isotopic steady state insulin was withdrawn and the study terminated after 600 minutes or earlier if blood glucose reached 18mmol/L, bicarbonate <15mmol/L, venous pH <7.35 or capillary ketones >5.0 mmol/L. </p> <p><br></p><p>Results: At baseline, glucose Ra was significantly higher with dapagliflozin than placebo. Following insulin withdrawal, plasma glucose concentrations at the end point were significantly lower with dapagliflozin than placebo and AUC<sub>0-180min </sub>glucose Rd and AUC<sub>0-180min </sub>β-hydroxybutyrate (BOHB) were significantly higher. There was a small but significantly higher AUC<sub>0-180min </sub>glycerol Ra (measure of lipolysis) with dapagliflozin. Non-esterified fatty acid concentrations were not different between treatments.</p> <p>When divided by BMI>27 and <27kg/m<sup>2</sup>, basal glucose Ra and BOHB, and AUC<sub>0-180min </sub>glycerol Ra were significantly higher in the low BMI group with dapaglifozin versus placebo treatment.</p> <p><br></p><p>Conclusions: During insulin withdrawal the increase in BOHB with dapaglifozin may be partially due to increased lipolysis. However reduced renal excretion, reduced BOHB uptake by peripheral tissues or a metabolic switch to increase ketogenesis within the liver may also play a role. <u></u></p>

Fifty-Two-Week Efficacy and Safety of Sotagliflozin, a Dual SGLT1 and SGLT2 Inhibitor, as Adjunct Therapy to Insulin in Adults with Type 1 Diabetes (inTandem1)

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 212-OR ◽  
Author(s):  
JOHN B. BUSE ◽  
SATISH K. GARG ◽  
JULIO ROSENSTOCK ◽  
TIMOTHY S. BAILEY ◽  
PHILLIP L. BANKS ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Sglt2 Inhibitor ◽  
Efficacy And Safety ◽  
Adjunct Therapy

12-OR: Metabolic Effects of Two Oral Insulin Dosing Regimens in Individuals at High Risk for Type 1 Diabetes (T1D)

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 12-OR
Author(s):  
MARIA J. REDONDO ◽  
JAY SOSENKO ◽  
EMILY K. SIMS ◽  
DAVID D. CUTHBERTSON ◽  
EDDIE A. JAMES ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
High Risk ◽  
Metabolic Effects ◽  
Oral Insulin ◽  
Dosing Regimens

scholarly journals Postprandial metabolic effects of fructose and glucose in type 1 diabetes patients: a pilot randomized crossover clinical trial

2019 ◽  
Author(s):  
Débora Lopes Souto ◽  
Érika dos Santos Lima ◽  
Joana Rodrigues Dantas ◽  
Lenita Zajdenverg ◽  
Melanie Rodacki ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Type 1 Diabetes ◽  
Metabolic Effects ◽  
Diabetes Patients

scholarly journals Metabolic effects of duodenojejunal bypass surgery in a rat model of type 1 diabetes

2020 ◽  
Author(s):  
Roman Vangoitsenhoven ◽  
Rickesha Wilson ◽  
Gautam Sharma ◽  
Suriya Punchai ◽  
Ricard Corcelles ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Rat Model ◽  
Bypass Surgery ◽  
Metabolic Effects ◽  
Duodenojejunal Bypass

scholarly journals Acute Metabolic Effects of Exenatide in Patients With Type 1 Diabetes With and Without Residual Insulin to Oral and Intravenous Glucose Challenges

Diabetes Care ◽  
2013 ◽  
Vol 37 (1) ◽  
pp. 210-216 ◽  
Author(s):  
Tara Ghazi ◽  
Linda Rink ◽  
Jennifer L. Sherr ◽  
Kevan C. Herold
Keyword(s):  
Type 1 Diabetes ◽  
Metabolic Effects ◽  
Intravenous Glucose

scholarly journals MP489RENOPROTECTIVE EFFECT OF SGLT2 INHIBITOR DAPAGLIFLOZIN IN TYPE- 1 DIABETES

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii608-iii608
Author(s):  
Dora Balogh ◽  
Judit Hodrea ◽  
Lilla Lenart ◽  
Adam Hosszu ◽  
Edgar Szkibinszkij ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Sglt2 Inhibitor
Sign in / Sign up

Export Citation Format

Share Document