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. KurianJake 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

Research output: Contribution to journalArticle

57 Scopus citations

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 DKAand 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.

Original languageEnglish (US)
Pages (from-to)1147-1154
Number of pages8
JournalDiabetes care
Volume42
Issue number6
DOIs
StatePublished - 2019

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

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    Danne, T., Garg, S., Peters, A. L., Buse, J. B., Mathieu, C., Pettus, J. H., Alexander, C. M., Battelino, T., Ampudia-Blasco, F. J., Bode, B. W., Cariou, B., Close, K. L., Dandona, P., Dutta, S., Ferrannini, E., Fourlanos, S., Grunberger, G., Heller, S. R., Henry, R. R., ... Phillip, M. (2019). International consensus on risk management of diabetic ketoacidosis in patients with type 1 diabetes treated with sodium-glucose cotransporter (SGLT) inhibitors. Diabetes care, 42(6), 1147-1154. https://doi.org/10.2337/dc18-2316