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Original Research
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, Moshe Phillip
Diabetes Care 2019 Feb; dc182316. https://doi.org/10.2337/dc18-2316
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Abstract

Sodium glucose cotransporter (SGLT) inhibitors are new oral antidiabetic 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 US Food and Drug Administration (FDA) and European regulatory agencies as an adjunct 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.

Footnotes

  • This article contains Supplementary Data online at http://care.diabetesjournals.org/lookup/suppl/doi:10.2337/dc18-2316/-/DC1.

  • Received November 6, 2018.
  • Accepted January 11, 2019.
  • © 2019 by the American Diabetes Association.
http://www.diabetesjournals.org/content/license

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.

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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, Moshe Phillip
Diabetes Care Feb 2019, dc182316; DOI: 10.2337/dc18-2316

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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, Moshe Phillip
Diabetes Care Feb 2019, dc182316; DOI: 10.2337/dc18-2316
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© 2021 by the American Diabetes Association. Diabetes Care Print ISSN: 0149-5992, Online ISSN: 1935-5548.