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sglt 2 diabetic ketoacidosis

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https://www.readbyqxmd.com/read/29602453/sglt2-inhibitor-induced-euglycaemic-diabetic-ketoacidosis-may-be-due-to-abrupt-severe-and-transient-impaired-glucose-sensing-in-susceptible-individuals-with-a-hitherto-unrecognised-beta-cell-sglt-variant
#1
F M Finucane
Euglycaemic diabetic ketoacidosis (EDKA) is a rare complication of treatment with SGLT2 inhibitors in patients with type 2 diabetes. Uncertainty remains about its precise mechanistic basis, but the physiological derangement is acute and profound, yet reversible with cessation of the drug. It is reminiscent of other "non type 1" presentations with DKA such as ketosis prone diabetes, except that glucose levels are usually normal. Impaired beta cell glucose sensing that mimicked a state of hypoglycaemia could theoretically lead to abrupt and transient cessation of insulin secretion...
May 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29569427/sodium-glucose-co-transporter-2-inhibitors-and-the-risk-for-diabetic-ketoacidosis-in-patients-with-type-2-diabetes-mellitus-a-nationwide-population-based-cohort-study
#2
Young-Gun Kim, Ja Young Jeon, Seung Jin Han, Dae Jung Kim, Kwan-Woo Lee, Hae Jin Kim
AIMS: The risk for diabetic ketoacidosis (DKA) associated with sodium-glucose co-transporter-2 inhibitor (SGLT-2i) treatment has not been established. Thus, we aimed to estimate the risk for DKA associated with SGLT-2i treatment compared to that with dipeptidyl-peptidase IV inhibitor (DPP-4i) treatment. METHODS: A nationwide population-based cohort study using claims data of the Korean Health Insurance Review and Assessment Service from January 1, 2013 to June 30, 2017 was performed...
March 22, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29542418/diabetic-ketoacidosis-in-patients-with-type-2-diabetes-on-sodium-glucose-cotransporter-2-inhibitors-a-case-series
#3
Purva Sharma, Yash Jobanputra, Karen Lewin, Stuart Bagatell, Daniel Lichtstein
BACKGROUND: Diabetic ketoacidosis (DKA) is a serious complication of diabetes seen commonly in autoimmune Type 1 diabetes mellitus (DM), however patients with Type 2 diabetes are also at risk. Diabetic ketoacidosis may be precipitated by the catabolic stress of acute illness such as trauma, surgery, or infections. Recent studies have suggested that sodium glucose cotransporter-2 (SGLT-2) inhibitors precipitate DKA in Type 2 diabetes. We present a case series of four patients on SGLT-2 inhibitors who presented with DKA...
March 13, 2018: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/29477576/sodium-glucose-cotransporter-2-inhibitors-induced-eu-glycemic-diabetic-ketoacidosis-the-first-report-in-a-type-2-diabetic-t2d-taiwanese-and-literature-review-of-possible-pathophysiology-and-contributing-factors
#4
Yi-Hsin Lin
Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are the newest class of oral antidiabetic drugs (OADs), approved to be a second-line OAD for type 2 diabetes in Taiwan since 2016. The U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) had both released statements associating the use of SGLT-2 inhibitors may increase the risk of eu-glycemic diabetic ketoacidosis (euDKA). This review reveals the possible pathophysiology with a chain of metabolic adaptions to decrease plasma glucose and increase plasma ketone bodies through pancreas, kidney, liver and adipose tissue...
February 21, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29451721/sodium-glucose-co-transporter-2-inhibitors-as-add-on-therapy-to-insulin-for-type-1-diabetes-mellitus-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#5
Tomohide Yamada, Nobuhiro Shojima, Hisashi Noma, Toshimasa Yamauchi, Takashi Kadowaki
New treatments for type 1 diabetes are an unmet need. We investigated the efficacy and safety of adding sodium-glucose co-transporter-2 (SGLT2) inhibitors to insulin for type 1 diabetes by conducting a meta-analysis of prospective randomized, placebo-controlled trials. A search of electronic databases up to October 2017 identified 1361 studies, of which 14 were investigated (N = 4591). Meta-analysis showed that SGLT2 inhibitor therapy significantly reduced glycated haemoglobin (HbA1c) concentration by 0.4% (95% confidence interval [CI] 0...
February 16, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29412120/sodium-glucose-cotransporter-2-inhibitors-and-the-risk-of-diabetic-ketoacidosis-from-pathophysiology-to-clinical-practice
#6
Dimitrios Patoulias, Alexandros Manafis, Christos Mitas, Konstantinos Avranas, Georgios Lales, Ioanna Zografou, Christos Sambanis, Asterios Karagiannis
BACKGROUND: SGLT-2 inhibitors are a novel class of antidiabetic drugs, recently approved for the treatment of patients with T2DM. Their cardioprotective and renoprotective action, along with their beneficial effects on metabolic parameters, make them an attractive therapeutic option. Since 2015, when the US FDA issued warning regarding the increased risk of euDKA in the setting of SGLT-2 inhibitors administration, a vivid discussion upon the direct connection between this novel class and the major metabolic complication of diabetes mellitus is still ongoing...
February 6, 2018: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/29368970/re-diabetic-ketoacidosis-in-patients-with-type-2-diabetes-on-sglt-2-inhibitors-an-ongoing-concern
#7
David S H Bell
No abstract text is available yet for this article.
January 2018: Endocrine Practice
https://www.readbyqxmd.com/read/29279644/canagliflozin-associated-diabetic-ketoacidosis-with-lower-than-anticipated-glucose-levels
#8
Sonali Vadi, Manjusha Agarwal
The Food and Drug Administration has approved the use of sodium-glucose co-transporter 2 (SGLT-2) inhibitors for use in Type II diabetics. These are a relatively new addition to the armamentaria of diabetes management. Postmarketing surveillance is a witness to several side effects, a morbid one being ketoacidosis. Herein is discussed a scenario of a Type II diabetic who presented with substantial ketoacidosis without significant hyperglycemia. The absence of the customary precipitating factors and the presence of a recent introduction of canagliflozin, a SGLT-2 inhibitor to the diabetes prescription, hinted at the causal relationship...
November 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29144574/sglt-2-inhibitors-and-ketoacidosis-a-disproportionality-analysis-in-the-world-health-organization-s-adverse-drug-reactions-database
#9
Abdel Nasser Ado Moumouni, Perrine Robin, Dominique Hillaire-Buys, Jean-Luc Faillie
SGLT-2 inhibitors, also called gliflozins, are a new class of drugs used in type 2 diabetes. Since their marketing, several cases of ketoacidosis, including life-threatening conditions, were reported with their use. The objective of this study was to investigate the disproportionality of pharmacovigilance reports of ketoacidosis between gliflozins and other drugs used for type 2 diabetes. We performed a case-noncase study within the World Health Organization's pharmacovigilance database, VigiBase. We selected all reports of serious adverse drug reaction associated with a glucose-lowering drug in patients aged 40 years and older, from January 2013 to March 2016...
November 16, 2017: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/28977090/use-of-sglt-2-inhibitors-in-the-treatment-of-type-2-diabetes-mellitus
#10
REVIEW
Leyna Leite Santos, Fernando José Camello de Lima, Célio Fernando de Sousa-Rodrigues, Fabiano Timbó Barbosa
INTRODUCTION: Diabetes mellitus is one of the most common chronic diseases in the world, with high morbidity and mortality rates, resulting in a greatly negative socioeconomic impact. Although there are several classes of oral antidiabetic agents, most of the patients are outside the therapeutic goal range. OBJECTIVE: To review the use of SGLT-2 inhibitors in the treatment of type 2 diabetes mellitus, focusing on their favorable and unfavorable effects, as well as on cardiovascular profile...
July 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28570924/effects-of-sglt-2-inhibitors-on-diabetic-ketoacidosis-a-meta-analysis-of-randomised-controlled-trials
#11
Matteo Monami, Besmir Nreu, Stefania Zannoni, Carlotta Lualdi, Edoardo Mannucci
AIMS: Diabetic ketoacidosis (DKA) associated with SGLT-2 inhibitors (SGLT-2i) is a possible adverse event. In fact, SGLT-2i are capable of stimulating the release of glucagon and ketone re-absorption in the renal tubuli, thus increasing the concentration of ketone bodies. METHODS: A Medline search for SGLT2i (dapagliflozin, empagliflozin, canagliflozin, ipragliflozin, ertugliflozin, luseogliflozin) was performed, collecting all randomized trials with a duration of treatment≥12weeks, enrolling patients with type 2 diabetes, and comparing a SGLT2i with placebo or other comparators...
August 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28535688/sglt-2-inhibitors-is-there-a-role-in-type-1-diabetes-mellitus-management
#12
REVIEW
Nabila Ahmed-Sarwar, Angela K Nagel, Samantha Leistman, Kevin Heacock
OBJECTIVE: The purpose of this review is to identify and evaluate disease management of patients with type 1 diabetes mellitus (T1DM) who were treated with a sodium-glucose cotransporter 2 (SGLT-2) inhibitor as an adjunct to insulin therapy. DATA SOURCES: A PubMed (1969 to March 2017) and Ovid (1946 to March 2017) search was performed for articles published utilizing the following MESH terms: canagliflozin, empagliflozin, dapagliflozin, type 1 diabetes mellitus, insulin dependent diabetes, insulin, sodium-glucose transporter 2...
September 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28437153/diabetic-ketoacidosis-in-patients-with-type-2-diabetes-recently-commenced-on-sglt-2-inhibitors-an-ongoing-concern
#13
LETTER
Mohamed Ahmed, Malachi J McKenna, Rachel K Crowley
OBJECTIVE: Sodium-glucose cotransporter 2 (SGLT-2) inhibitors are increasingly used as an adjunctive treatment for type 2 diabetes. We report the occurrence of diabetic ketoacidosis (DKA) in 3 patients with type 2 diabetes recently commenced on SGLT-2 inhibitors. METHODS: Clinical presentation, laboratory data, and treatment outcomes of all 3 cases are described. RESULTS: All 3 patients had documented history of longstanding type 2 diabetes...
April 2, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28276512/the-efficacy-and-safety-of-sglt2-inhibitors-for-adjunctive-treatment-of-type-1-diabetes-a-systematic-review-and-meta-analysis
#14
Jiao Chen, Fang Fan, J Y Wang, Yang Long, C L Gao, R C Stanton, Yong Xu
To assess the efficacy and safety of the SGLT-2 inhibitors as adjunct therapy to insulin in T1DM, clinical trials indexed in PubMed, Cochrane Library, EMbase from inception through April 5, 2016. A meta-analysis was conducted on trials of SGLT-2 inhibitors in patients with T1DM on insulin therapy using RevMan 5.3 software. Of the 371 articles identified, ten met eligibility criteria. Seven clinical trials including four randomized controlled trials and 581 patients were included. Compared with the control group, SGLT-2 inhibitors group had significantly reduced fasting plasma glucose by 0...
March 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/27918226/canagliflozin-use-in-type-i-diabetes-mellitus
#15
COMMENT
Robert Guthrie
Peters et al documented the appearance of diabetic ketoacidosis without significant elevation of serum glucose in patients treated with Canagliflozin. They solicited patient reports from their practice and from other colleagues' practices and identified nine patients, mainly with Type I Diabetes. Erondu et al evaluated the Canagliflozin development data base to describe the rate and appearance of ketoacidosis in the study patients. They found that in the research patients with Type 2 Diabetes, the rate of ketoacidosis in Canagliflozin patients was uncommon and similar to the reported rate in Type 2 patients not receiving Canagliflozin...
April 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/27913012/hyperglycemic-high-anion-gap-metabolic-acidosis-in-patients-receiving-sglt-2-inhibitors-for-diabetes-management
#16
Juliette Sandifer Kum-Nji, Aidar R Gosmanov, Helmut Steinberg, Samuel Dagogo-Jack
Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) are a class of antidiabetic medications that improve glycemic control via inhibiting the reabsorption of filtered glucose and are approved for use in type 2 diabetes (T2DM). These drugs have recently been associated with euglycemic diabetic ketoacidosis (DKA). An increasing number of cases of SGLT-2i-associated DKA have occurred in patients with T2DM. Herein, we describe five episodes of hyperglycemic DKA in four type 2 diabetes patients receiving SGLT-2i therapy...
March 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/27908315/-life-threatening-ketoacidosis-in-a-25-year-old-woman-treated-with-sodium-glucose-cotransporter-2-inhibitor
#17
Mats Jacob Hermansson Lindberg, Frans Brandt Kristensen, Alev Yildiz
We report a case of atypical ketoacidosis in a patient treated with a sodium-glucose cotransporter- (SGLT) 2 inhibitor. The 25-year-old woman, who one year earlier had been prescribed dapagliflozin for presumed Type 2 diabetes, came to the emergency department in a state of severe ketoacidosis, pH 6.85, and a plasma glucose level of 14.3 mmol/l. She received standard treatment and recovered. We discuss the increasing evidence for atypical ketoacidosis being a serious side effect of the SGLT2 inhibitors.
November 21, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/27867961/cardio-renal-protection-with-empagliflozin
#18
Richard J MacIsaac, George Jerums, Elif I Ekinci
Cardiovascular (CV) and kidney disease are common and significant complications in people with type 2 diabetes (T2DM). CV disease is the leading cause of death, morbidly and hospitalisations for people with T2DM. Furthermore, diabetic kidney disease is a major risk factor for CV disease and is the main reason why patients need renal replacement therapy. In this perspective, we highlight the results of the recent landmark EMPA-REG OUTCOME trial which has shown that empagliflozin, a member of the sodium-glucose co-transporter 2 (SGLT-2) inhibitor class of glucose lowering medications, reduces death from CV causes, hospitalisation for heart failure and progression to end stage kidney disease in patients with T2DM and established CV disease...
October 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27649712/-sodium-glucose-cotransporter-2-sglt-2-inhibitors-for-patients-with-type-2-diabetes
#19
Michael Einar Røder, Heidi Storgaard, Jørgen Rungby, Filip Krag Knop, Tina Vilsbøll
The sodium-glucose cotransporter 2 inhibitor (SGLT-2i)-class is efficacious as monotherapy and as add-on therapy with an expected lowering of the glycated haemoglobin (HbA1c) concentration of approximately 7 mmol/mol. Side effects relate to the mode of action, genital infections are the main problem. Extremely rare cases of ketoacidosis are reported, mostly in patients with Type 1 diabetes. One SGLT-2i, empagliflozin, has been shown to reduce cardiovascular mortality and progression of kidney disease in patients with Type 2 diabetes and cardiovascular disease...
September 19, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/27635409/canagliflozin-induced-diabetic-ketoacidosis-case-report-and-review-of-the-literature
#20
Jessica Turner, Tahmina Begum, Roger D Smalligan
INTRODUCTION: Sodium-glucose co-transporter 2 (SGLT-2) inhibitors are relatively new antihyperglycemic agents that lower renal glucose reabsorption. They are used as adjunctive therapy to standard diabetes treatment. CASE REPORT: We present the case of a 62-year-old woman with a past medical history of type 2 diabetes mellitus and sudden-onset diabetic ketoacidosis (DKA). Use of canagliflozin, a SGLT-2 inhibitor, was determined to be the cause of the DKA. The patient ultimately recovered after 5 days in the intensive care unit...
July 2016: Journal of Investigative Medicine High Impact Case Reports
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