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

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

^*Corresponding author for this work

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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 language	English
Pages (from-to)	1147-1154
Number of pages	8
Journal	Diabetes Care
Volume	42
Issue number	6
DOIs	https://doi.org/10.2337/dc18-2316
State	Published - 2019

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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

@article{6594775c511d4ea68e8223251ccef9ba,

title = "International consensus on risk management of diabetic ketoacidosis in patients with type 1 diabetes treated with sodium-glucose cotransporter (SGLT) inhibitors",

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.",

author = "Thomas Danne and Satish Garg and Peters, {Anne L.} and Buse, {John B.} and Chantal Mathieu and Pettus, {Jeremy H.} and Alexander, {Charles M.} and Tadej Battelino and Ampudia-Blasco, {F. Javier} and Bode, {Bruce W.} and Bertrand Cariou and Close, {Kelly L.} and Paresh Dandona and Sanjoy Dutta and Ele Ferrannini and Spiros Fourlanos and George Grunberger and Heller, {Simon R.} and Henry, {Robert R.} and Kurian, {Martin J.} and Kushner, {Jake A.} and Tal Oron and Parkin, {Christopher G.} and Pieber, {Thomas R.} and Rodbard, {Helena W.} and Desmond Schatz and Skyler, {Jay S.} and Tamborlane, {William V.} and Koutaro Yokote and Moshe Phillip",

note = "Publisher Copyright: {\textcopyright} 2019 by the American Diabetes Association.",

year = "2019",

doi = "10.2337/dc18-2316",

language = "אנגלית",

volume = "42",

pages = "1147--1154",

journal = "Diabetes Care",

issn = "1935-5548",

publisher = "American Diabetes Association Inc.",

number = "6",

}

Danne, T, Garg, S, Peters, AL, Buse, JB, Mathieu, C, Pettus, JH, Alexander, CM, Battelino, T, Ampudia-Blasco, FJ, Bode, BW, Cariou, B, Close, KL, Dandona, P, Dutta, S, Ferrannini, E, Fourlanos, S, Grunberger, G, Heller, SR, Henry, RR, Kurian, MJ, Kushner, JA, Oron, T, Parkin, CG, Pieber, TR, Rodbard, HW, Schatz, D, Skyler, JS, Tamborlane, WV, Yokote, K & 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, vol. 42, no. 6, pp. 1147-1154. https://doi.org/10.2337/dc18-2316

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AU - Danne, Thomas

AU - Garg, Satish

AU - Peters, Anne L.

AU - Buse, John B.

AU - Mathieu, Chantal

AU - Pettus, Jeremy H.

AU - Alexander, Charles M.

AU - Battelino, Tadej

AU - Ampudia-Blasco, F. Javier

AU - Bode, Bruce W.

AU - Cariou, Bertrand

AU - Close, Kelly L.

AU - Dandona, Paresh

AU - Dutta, Sanjoy

AU - Ferrannini, Ele

AU - Fourlanos, Spiros

AU - Grunberger, George

AU - Heller, Simon R.

AU - Henry, Robert R.

AU - Kurian, Martin J.

AU - Kushner, Jake A.

AU - Oron, Tal

AU - Parkin, Christopher G.

AU - Pieber, Thomas R.

AU - Rodbard, Helena W.

AU - Schatz, Desmond

AU - Skyler, Jay S.

AU - Tamborlane, William V.

AU - Yokote, Koutaro

AU - Phillip, Moshe

PY - 2019

Y1 - 2019

N2 - 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.

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ER -

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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