Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Jun;42(6):1147-1154.
doi: 10.2337/dc18-2316. Epub 2019 Feb 6.

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

Thomas Danne  1 , Satish Garg  2 , Anne L Peters  3 , John B Buse  4 , Chantal Mathieu  5 , Jeremy H Pettus  6 , Charles M Alexander  7 , Tadej Battelino  8 , F Javier Ampudia-Blasco  9 , Bruce W Bode  10 , Bertrand Cariou  11 , Kelly L Close  12 , Paresh Dandona  13 , Sanjoy Dutta  14 , Ele Ferrannini  15 , Spiros Fourlanos  16 , George Grunberger  17 , Simon R Heller  18 , Robert R Henry  6 , Martin J Kurian  19 , Jake A Kushner  20 , Tal Oron  21   22 , Christopher G Parkin  23 , Thomas R Pieber  24 , Helena W Rodbard  25 , Desmond Schatz  26 , Jay S Skyler  27 , William V Tamborlane  28 , Koutaro Yokote  29 , Moshe Phillip  21   22
Affiliations
Review

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

Thomas Danne et al. Diabetes Care. 2019 Jun.

Abstract

Sodium-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.

PubMed Disclaimer

References

    1. Cryer PE. Hypoglycemia: still the limiting factor in the glycemic management of diabetes. Endocr Pract 2008;14:750–756 - PubMed
    1. Polonsky WH, Anderson BJ, Lohrer PA, Aponte JE, Jacobson AM, Cole CF. Insulin omission in women with IDDM. Diabetes Care 1994;17:1178–1185 - PubMed
    1. Polonsky WH, Anderson BJ, Lohrer PA, et al. . Assessment of diabetes-related distress. Diabetes Care 1995;18:754–760 - PubMed
    1. Peyrot M, Skovlund SE, Landgraf R. Epidemiology and correlates of weight worry in the multinational Diabetes Attitudes, Wishes and Needs study. Curr Med Res Opin 2009;25:1985–1993 - PubMed
    1. U.S. Food and Drug Administration FDA warns that SGLT2 inhibitors for diabetes may result in a serious condition of too much acid in the blood [Internet], 15 May 2015. Available from https://www.fda.gov/downloads/drugs/drugSafety/ucm446954.pdf. Accessed 25 May 2018

Publication types