scholarly journals Comment on Herring et al. 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;43:2128–2136

Diabetes Care ◽  
2021 ◽  
Vol 44 (3) ◽  
pp. e59-e60
Author(s):  
Geremia B. Bolli ◽  
Francesca Porcellati ◽  
Paola Lucidi ◽  
Carmine G. Fanelli
Keyword(s):  
Type 1 Diabetes ◽  
Diabetes Care ◽  
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 At isotopic steady state insulin was withdrawn and the study terminated after 600 minutes or earlier if blood glucose reached 18mmol/L, bicarbonate 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

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>

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

scholarly journals Response to Comment on Sarkar et al. Exenatide Treatment for 6 Months Improves Insulin Sensitivity in Adults With Type 1 Diabetes. Diabetes Care 2014;37:666–670

Diabetes Care ◽  
2014 ◽  
Vol 37 (10) ◽  
pp. e219-e220
Author(s):  
Gayatri Sarkar ◽  
May Alattar ◽  
Rebecca J. Brown ◽  
Michael J. Quon ◽  
David M. Harlan ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Sensitivity ◽  
Diabetes Care

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 Diabetes Care, Glycemic Control, Complications, and Concomitant Autoimmune Diseases in Children with Type 1 Diabetes in Turkey: A Multicenter Study

2013 ◽  
Vol 5 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Gökşen Şimşek Damla ◽  
Aycan Zehra ◽  
Özen Samim ◽  
Çetinkaya Semra ◽  
Kara Cengiz ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Autoimmune Diseases ◽  
Multicenter Study ◽  
Diabetes Care
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