• Diabetes care · Jun 2019

    Comment Review

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

    • Thomas Danne, Satish Garg, Anne L Peters, John B Buse, Chantal Mathieu, Jeremy H Pettus, Charles M Alexander, Tadej Battelino, F Javier Ampudia-Blasco, Bruce W Bode, Bertrand Cariou, Kelly L Close, Paresh Dandona, Sanjoy Dutta, Ele Ferrannini, Spiros Fourlanos, George Grunberger, Simon R Heller, Robert R Henry, Martin J Kurian, Jake A Kushner, Tal Oron, Christopher G Parkin, Thomas R Pieber, Helena W Rodbard, Desmond Schatz, Jay S Skyler, William V Tamborlane, Koutaro Yokote, and Moshe Phillip.
    • Diabetes Centre for Children and Adolescents, Kinder- und Jugendkrankenhaus Auf der Bult, Hannover, Germany.
    • Diabetes Care. 2019 Jun 1; 42 (6): 1147-1154.

    AbstractSodium-glucose cotransporter (SGLT) inhibitors are new oral antidiabetes medications shown to effectively reduce glycated hemoglobin (A1C) and glycemic variability, blood pressure, and body weight without intrinsic properties to cause hypoglycemia in people with type 1 diabetes. However, recent studies, particularly in individuals with type 1 diabetes, have demonstrated increases in the absolute risk of diabetic ketoacidosis (DKA). Some cases presented with near-normal blood glucose levels or mild hyperglycemia, complicating the recognition/diagnosis of DKA and potentially delaying treatment. Several SGLT inhibitors are currently under review by the U.S. Food and Drug Administration and European regulatory agencies as adjuncts to insulin therapy in people with type 1 diabetes. Strategies must be developed and disseminated to the medical community to mitigate the associated DKA risk. This Consensus Report reviews current data regarding SGLT inhibitor use and provides recommendations to enhance the safety of SGLT inhibitors in people with type 1 diabetes.© 2019 by the American Diabetes Association.

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