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

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

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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, …

Diabetes care, Vol.42(6), pp.1147-1154

2019-06

DOI: https://doi.org/10.2337/dc18-2316

PMID: 30728224

Abstract

Diabetic Ketoacidosis

Hypoglycemic Agents

Sodium

Humans

Diabetes Mellitus, Type 1

Sodium-Glucose Transporter 2 Inhibitors

Diabetes Mellitus, Type 2

Glucose

Consensus

Risk Management

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.

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Collaboration types: Domestic collaboration; International collaboration
Citation topics: 1 Clinical & Life Sciences; 1.26 Diabetes; 1.26.831 GLP-1
Web Of Science research areas: Endocrinology & Metabolism
ESI research areas: Clinical Medicine

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Title: International Consensus on Risk Management of Diabetic Ketoacidosis in Patients With Type 1 Diabetes Treated With Sodium-Glucose Cotransporter (SGLT) Inhibitors
Creators: Thomas Danne - Diabetes Centre for Children and Adolescents, Kinder- und Jugendkrankenhaus Auf der Bult, Hannover, Germany
Satish Garg - University of Colorado Denver and Barbara Davis Center for Diabetes, Aurora, CO
Anne L Peters - Keck School of Medicine of the University of Southern California, Los Angeles, CA
John B Buse - University of North Carolina School of Medicine, Chapel Hill, NC
Chantal Mathieu - Department of Endocrinology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium
Jeremy H Pettus - Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Diego, San Diego, CA
Charles M Alexander - Alexander Associates LLC, Gwynedd Valley, PA
Tadej Battelino - Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, University Children's Hospital, University Medical Centre Ljubljana, and Faculty of Medicine, University of Ljubljana, Slovenia
F Javier Ampudia-Blasco - Clinic University Hospital of Valencia, Valencia, Spain
Bruce W Bode - Atlanta Diabetes Associates, Atlanta, GA
Bertrand Cariou - Clinique d'endocrinologie, L'institut du thorax, CHU Nantes, CIC 1413 INSERM, Nantes, France
Kelly L Close - The diaTribe Foundation, San Francisco, CA
Paresh Dandona - Division of Endocrinology, Diabetes and Metabolism, University at Buffalo, The State University of New York, Buffalo, NY
Sanjoy Dutta - JDRF International, New York, NY
Ele Ferrannini - National Research Council (CNR) Institute of Clinical Physiology, Pisa, Italy
Spiros Fourlanos - Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, Australia
George Grunberger - Grunberger Diabetes Institute, Bloomfield Hills, MI
Simon R Heller - Academic Unit of Diabetes, Endocrinology & Metabolism, University of Sheffield, Sheffield, U.K
Robert R Henry - Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Diego, San Diego, CA
Martin J Kurian - Close Concerns, San Francisco, CA
Jake A Kushner - McNair Interests, Houston, TX
Tal Oron - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Christopher G Parkin - CGParkin Communications, Inc., Boulder City, NV chris@cgparkin.org
Thomas R Pieber - Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
Helena W Rodbard - Endocrine and Metabolic Consultants, Rockville, MD
Desmond Schatz - Division of Endocrinology, Department of Pediatrics, University of Florida, Gainesville, FL
Jay S Skyler - Division of Endocrinology, Diabetes and Metabolism, Miller School of Medicine, University of Miami, Miami, FL
William V Tamborlane - Department of Pediatrics, Yale School of Medicine, New Haven, CT
Koutaro Yokote - Department of Diabetes, Metabolism and Endocrinology, Chiba University Graduate School of Medicine, Chiba, Japan
Moshe Phillip - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Publication Details: Diabetes care, Vol.42(6), pp.1147-1154
Publisher: United States
Grant note: UL1 TR002489 / NCATS NIH HHS UL1 TR001863 / NCATS NIH HHS
Academic Unit: Miller School of Medicine; Diabetes Research Institute (DRI)
Language: English
Resource Type: Journal article
PMID: 30728224
Record Identifier: 991031576567602976