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SGLT inhibition in T1DM — definite benefit with manageable risk

Two phase III trials using the selective SGLT2 inhibitor dapagliflozin or the dual SGLT2/SGLT1 inhibitor sotagliflozin in patients with type 1 diabetes mellitus show similar clinical benefit (reduction of HbA1c, body weight, blood pressure and insulin dose). The risk of hypoglycaemia and diabetic ketoacidosis with these inhibitors can be managed by careful adjustment of insulin therapy.

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References

  1. Ferrannini, E. Sodium-glucose co-transporters and their inhibition: clinical physiology. Cell Metab. 26, 27–38 (2017).

    Article  CAS  Google Scholar 

  2. Zinman, B. et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N. Engl. J. Med. 373, 2117–2128 (2015).

    Article  CAS  Google Scholar 

  3. Neal, B. et al. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N. Engl. J. Med. 377, 644–657 (2017).

    Article  CAS  Google Scholar 

  4. Miller, K. M. et al. Current state of type 1 diabetes treatment in the U.S.: updated data from the T1D exchange clinic registry. Diabetes Care 38, 971–978 (2015).

    Article  Google Scholar 

  5. Lyons, S. K. et al. Use of adjuvant pharmacotherapy: international comparison of 49,367 individuals in the diabetes rospective follow-up and T1D exchange registries. Diabetes Care 40, e139–e140 (2017).

    Article  Google Scholar 

  6. Dandona, P. et al. Efficacy and safety of dapagliflozin in patients with inadequately controlled type 1 diabetes (DEPICT-1): 24 week results from a multicentre, double-blind, phase 3, randomised controlled trial. Lancet Diabetes Endocrinol. http://dx.doi.org/10.1016/S2213-8587(17)30308-X (2017).

  7. Garg, S. K. et al. Effects of sotagliflozin added to insulin in patients with type 1 diabetes. N. Engl. J. Med. http://dx.doi.org/10.1056/NEJMoa1708337 (2017).

  8. Lapuerta, P. et al. Development of sotagliflozin, a dual sodium-dependent glucose transporter 1/2 inhibitor. Diab. Vasc. Dis. Res. 12, 101–110 (2015).

    Article  CAS  Google Scholar 

  9. Rosenstock, J. & Ferrannini, E. Euglycemic diabetic ketoacidosis: a predictable, detectable, and preventable safety concern with SGLT2 inhibitors. Diabetes Care 38, 1638–1642 (2015).

    Article  CAS  Google Scholar 

  10. Handelsman, Y. et al. American Association of Clinical Endocrinologists and American College of Endocrinology position statement on the association of SGLT-2 inhibitors and diabetic ketoacidosis. Endocr. Pract. 22, 753–762 (2016).

    Article  Google Scholar 

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Correspondence to Ele Ferrannini.

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Ferrannini, E., Solini, A. SGLT inhibition in T1DM — definite benefit with manageable risk. Nat Rev Endocrinol 13, 698–699 (2017). https://doi.org/10.1038/nrendo.2017.139

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