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Risk Of Diabetic Ketoacidosis After Initiation Of An Sglt2 Inhibitor

Sglt2 Inhibitors Side Effects

Sglt2 Inhibitors Side Effects

Sodium-glucose cotransporter-2 (SGLT2) inhibitors are intended to treat Type 2 diabetes along with diet and exercise. They have also been prescribed for off-label, or unapproved, uses including weight loss. The active ingredients in the drugs are different gliflozin compounds. SGLT2 inhibitors approved for use in the U.S. include: In addition, some medications combine SGLT2 inhibitors with other diabetes drugs. These include: Metformin decreases glucose production in the liver while increasing the body’s ability to absorb glucose. It is often used in conjunction with insulin as well as SGLT2 inhibitors to treat Type 2 diabetes. It carries additional risks of side effects. Linagliptin works by regulating insulin levels after meals. When first approved, SGLT2 inhibitors took a revolutionary approach to controlling blood sugar in diabetic patients. The drugs cause the body to direct excess glucose to the kidneys. From there, it is expelled through a patient’s urine. SGLT2 Inhibitor Side Effects Range from Minor to Life-Threatening While the way SGLT2 drugs work is unique, this can also lead to unique side effects. For example, because the drugs cause excess sugar to escape the body in urine, it can also lead to yeast infections and urinary tract infections. The drugs primarily work in the kidneys, so these drugs are not for people with weak kidney function. Some studies also show these drugs may lead to dangerous kidney infections and kidney failure. Side effects can lead from simple annoyances such as dry mouth to more serious complications including kidney injuries. Common SGLT2 Inhibitor Side Effect Symptoms: Abdominal pain Back pain Constipation Dry mouth Fatigue Increased cholesterol Increased urination Influenza Male and female yeast infections Nausea Thirst Urin Continue reading >>

Are Sglt2 Inhibitors Linked To Increased Risk Of Diabetic Ketoacidosis?

Are Sglt2 Inhibitors Linked To Increased Risk Of Diabetic Ketoacidosis?

Are SGLT2 Inhibitors Linked to Increased Risk of Diabetic Ketoacidosis? Sodiumglucose cotransporter 2 (SGLT2) inhibitors were associated with an almost 2-times greater risk of diabetic ketoacidosis in patients with diabetes, according to a recent research letter. The researchers identified 50,220 patients who had received a new prescription for an SGLT2 inhibitor and 90,132 patients who had received a new prescription for a dipeptidyl peptidase-4 (DPP4) inhibitor between April 1, 2013 and December 31, 2014 on the Truven MarketScan database. Hospitalization for diabetic ketoacidosis within 180 days after initiating treatment with an SGLT2 or DPP4 inhibitor was assessed as the primary outcome. ____________________________________________________________________________________________________________________ FDA Raises Kidney Warning with SGLT2 Inhibitors ____________________________________________________________________________________________________________________ Patients who were prescribed SGLT2 inhibitors were younger and had fewer comorbidities compared with patients who were prescribed DPP4 inhibitors, but were more likely to receive insulin. Before propensity-score matching, the unadjusted rate of diabetic ketoacidosis within 180 days of initiation of an SGLT2 inhibitor was about twice the rate after initiation of a DPP4 inhibitor (4.9 events per 1000 person-years vs 2.3 events per 1000 person-years) (hazard ratio 2.1). After propensity-score matching, the hazard ratio was 2.2 for patients taking SGLT2 inhibitors. Shortly after initiation, SGLT2 inhibitors were associated with approximately twice the risk of diabetic ketoacidosis as were DPP4 inhibitors, although cases of diabetic ketoacidosis leading to hospitalization were infrequent, the researchers concl Continue reading >>

Diabetic Ketoacidosis Risk Up With Sglt2 Inhibitors In T2dm

Diabetic Ketoacidosis Risk Up With Sglt2 Inhibitors In T2dm

Diabetic Ketoacidosis Risk Up With SGLT2 Inhibitors in T2DM Diabetic Ketoacidosis Risk Up With SGLT2 Inhibitors in T2DM The investigators found that patients taking SGLT2 inhibitors were approximately twice as likely to develop diabetic ketoacidosis than those taking DPP4 inhibitors. (HealthDay News) Sodium-glucose cotransporter 2 (SGLT2) inhibitors appear to increase the risk of diabetic ketoacidosis in patients with type 2 diabetes, according to a research letter published in the New England Journal of Medicine. Researchers at Brigham and Women's Hospital in Boston analyzed data from 38,045 patients taking SGLT2 inhibitors and compared their outcomes to those of 38,045 patients taking a dipeptidyl peptidase-4 (DPP4) inhibitor. The team excluded patients with HIV infection, end-stage renal disease, cancer, type 1 diabetes, or past diabetic ketoacidosis. The investigators found that patients taking SGLT2 inhibitors were approximately twice as likely to develop diabetic ketoacidosis than those taking DPP4 inhibitors (4.9 events per 1,000 person-years vs 2.3 events per 1,000 person-years). "This is a side effect that's usually seen in patients with type 1 diabetes mellitus not type 2 so doctors are not 'on the lookout' for it," study author Michael Fralick, MD, from Brigham and Women's division of pharmacoepidemiology and pharmacoeconomics, said in a hospital news release. "That means that the risk of this side effect might actually be even higher than what we found due to misdiagnosis/under-recording." Metformin, Sitagliptin Aid Diabetic Ketoacidosis Recovery Fralick M, Schneeweiss S, Patorno E. Risk of Diabetic Ketoacidosis after Initiation of an SGLT2 Inhibitor. N Engl J Med . 8 June 2017. doi: 10.1056/NEJMc1701990 Continue reading >>

Sglt2 Inhibitors And The Risk Of Diabetic Ketoacidosis| Dailyrounds

Sglt2 Inhibitors And The Risk Of Diabetic Ketoacidosis| Dailyrounds

SGLT2 Inhibitors and the Risk of Diabetic Ketoacidosis SGLT2 Inhibitors and the Risk of Diabetic Ketoacidosis SGLT2 inhibitors decrease plasma glucose by blocking the reabsorption of glucose at the proximal tubule. Case reports have suggested that SGLT2 inhibitors may be associated with an increased risk of diabetic ketoacidosis, which led to a warning from the FDA in May 2015. The results of the largest study conducted to date to investigate the issue were published as a research letter in the June 8 issue of the New England Journal of Medicine. 1. The overall absolute risk is low. However, the risk of developing DKA among type 2 diabetes patients initiating a SGLT2 inhibitor is about double that seen among patients starting a dipeptidyl peptidase-4 (DPP-4) inhibitor. 2. An estimated 5 to 8 patients per 1000 initiating SGLT2 inhibitors will develop DKA. 3. Patients should be strictly monitored for signs of DKA after starting on SGLT2 inhibitors. Using a large claims database of commercially insured patients in the United States (Truven MarketScan), authors identified a cohort of adult patients (18 years of age) who had newly started treatment with either an SGLT2 inhibitor or a dipeptidyl peptidase-4 (DPP4) inhibitor between April 1, 2013, and December 31, 2014 (before the FDA warning). DPP4 inhibitors were chosen as the comparator medication because they are similarly used as a second-line treatment for diabetes but have no known association with diabetic ketoacidosis. Patients with human immunodeficiency virus infection, end-stage renal disease, cancer, type 1 diabetes, or past diabetic ketoacidosis were excluded. The primary outcome was hospitalization for diabetic ketoacidosis (using the primary position code of the International Classification of Diseases, Ninth Continue reading >>

Correspondence: Risk Of Diabetic Ketoacidosis After Initiation Of An Sglt2 Inhibitor - Scoopnest.com

Correspondence: Risk Of Diabetic Ketoacidosis After Initiation Of An Sglt2 Inhibitor - Scoopnest.com

correspondence: risk of diabetic ketoacidosis after initiation of an sglt2 inhibitor Correspondence: Risk of Diabetic Ketoacidosis after Initiation of an SGLT2 Inhibitor When @IvankaTrump & [email protected] their tax cuts roadtrip, I hope they can explain this [email protected] to me... US only advanced economy to increase dept-to-GDP ratio #fiscalmonitors #debtratio The U.K. just went 55 hours without using coal for the first time in history This is just brilliant - this map shows the biggest trading partner for each country 11 cross-party Select Committee Chairs, led by Yvette Cooper & Nicky Morgan join forces for a Commons next Thursday vote on the UK negotiating an effective customs union with EU for economy, Irish border... backed by 4 Conservative MPs already: JUST IN: Russia demands compensation at World Trade Organization for U.S. steel and aluminium tariffs, following similar move by China, India and EU - WTO filing In Myanmar the 90% Buddhist majority felt so threatened by a Muslim minority of barely 1% that it sanctioned murder, rape and enforced exile The late 19th century saw America suffering from similar problems to those of today. Rather than dying, liberalism reformed itself #OpenFuture At the heart of Donald Trump's system of power is his attitude to the truth: it is what he can get away with Takeda offers $60 billion for drugmaker Shire, Reuters reports A cinema opening is a tangible sign of change in Saudi Arabia, where Western-style entertainment has often been banned Scoopnest is a web media which finds for you the best tweets in real time! Get the top latest buzz on Twitter about everything you like : Breaking news, Sports, People, Fashion, Business, Entertainment, Health, Technology, Finance, etc... We sort and classify the best buzzing tweets Continue reading >>

Sodium-glucose Cotransporter-2 Inhibitors | Sglt2 Inhibitor Initiation Linked To Raised Diabetic Ketoacidosis Risk | Diabetes.medicinematters.com

Sodium-glucose Cotransporter-2 Inhibitors | Sglt2 Inhibitor Initiation Linked To Raised Diabetic Ketoacidosis Risk | Diabetes.medicinematters.com

SGLT2 inhibitor initiation linked to raised diabetic ketoacidosis risk medwireNews: Research findings indicate that patients with type 2 diabetes may have an increased risk for diabetic ketoacidosis when they begin treatment with a sodiumglucose cotransporter 2 (SGLT2) inhibitor. The risk was increased around twofold during the first 180days after initiating an SGLT2 inhibitor, relative to the same period after starting treatment with a dipeptidyl peptidase (DPP)-4 inhibitor. The absolute risk was very low, however, with just 55 of 38,045 patients in the SGLT2 inhibitor group experiencing this outcome. These patients were matched for the propensity to receive an SGLT2 inhibitor with 38,045 patients given a DPP-4 inhibitor, 26 of whom had diabetic ketoacidosis during the first 180days after they started treatment. The increased risk in the SGLT2 inhibitor group persisted when the analysis was restricted to patients not taking insulin. In a press statement, lead researcher Michael Fralick (Brigham and Womens Hospital, Boston, Massachusetts, USA) observed that diabetic ketoacidosis is usually associated with type 1 diabetes, rather than type 2, so doctors are not on the lookout for it. He added: That means that the risk of this side effect might actually be even higher than what we found due to misdiagnosis/under recording. Continue reading >>

Risk Of Diabetic Ketoacidosis After Initiation Of An Sglt2 Inhibitor

Risk Of Diabetic Ketoacidosis After Initiation Of An Sglt2 Inhibitor

To the Editor: Inhibitors of sodium–glucose cotransporter 2 (SGLT2) decrease plasma glucose by blocking the reabsorption of glucose at the proximal tubule.1,2 Case reports have suggested that SGLT2 inhibitors may be associated with an increased risk of diabetic ketoacidosis, which led to a warning from the Food and Drug Administration (FDA) in May 2015.3,4 The objective of our study was to assess the risk of diabetic ketoacidosis after the initiation of an SGLT2 inhibitor. Using a large claims database of commercially insured patients in the United States (Truven MarketScan), we identified a cohort of adult patients (≥18 years of age) who had newly started treatment with either an SGLT2 inhibitor or a dipeptidyl peptidase-4 (DPP4) inhibitor between April 1, 2013, and December 31, 2014 (before the FDA warning). DPP4 inhibitors were chosen as the comparator medication because they are similarly used as a second-line treatment for diabetes but have no known association with diabetic ketoacidosis. We excluded patients with human immunodeficiency virus infection, end-stage renal disease, cancer, type 1 diabetes, or past diabetic ketoacidosis. Our primary outcome was hospitalization for diabetic ketoacidosis (using the primary position code of the International Classification of Diseases, Ninth Revision) within 180 days after the initiation of an SGLT2 inhibitor or a DPP4 inhibitor. We censored data for patients at the time that they discontinued the initial medication, had the outcome, lost insurance coverage, or died. We used 1:1 propensity-score matching to balance 46 characteristics of the patients and Cox regression to estimate hazard ratios and 95% confidence intervals for diabetic ketoacidosis within 180 days after treatment initiation. Predefined sensitivity analy Continue reading >>

Sglt2 Inhibitors Double The Risk For Diabetic Ketoacidosis. N Engl J Med

Sglt2 Inhibitors Double The Risk For Diabetic Ketoacidosis. N Engl J Med

SGLT2 Inhibitors Double the Risk for Diabetic Ketoacidosis. N Engl J Med The risk of developing diabetic ketoacidosis (DKA) among type 2 diabetes patients initiating a sodiumglucose cotransporter 2 (SGLT2) inhibitor medication is about double that seen among patients starting a dipeptidyl peptidase-4 (DPP-4) inhibitor, but the overall risk is still low, new research suggests. Findings from the largest study conducted to date to investigate the issue werepublishedas a research letter in the June 8 issue of theNew England Journal of Medicineby Michael Fralick, MD, and colleagues at the Brigham and Women's Hospital, Boston, Massachusetts. "We found a doubling in the risk of DKA, which sounds frightening, but the absolute risk is quite small....I still think this is a very good class of medications and for certain patients will continue to be. Now we just have a little more information to add to the discussion when the risks and benefits are being considered," Dr Fralick toldMedscape Medical News. He estimates that between 5 and 8 patients per 1000 initiating SGLT2 inhibitors will develop DKA. And he advisesthat patients be monitored for signs of DKA or full information to thew patients of the symtoms of DKA to seek help if DKA appears after starting on SGLT2 inhibitors, noting, "This is something that can happen relatively quickly, so that's why I think it's important right after patients are started on these drugs that they're closely monitored and the clinician considers ordering bloodwork." But overall, Dr Fralick, a general internist, supports use of the SGLT2 inhibitor class for selected patients with type 2 diabetes, given the recent results from theEmpagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients(EMPA-REG OUTCOME) study showing Continue reading >>

Understanding Sglt2 Inhibitors' Diabetic Ketoacidosis Risk

Understanding Sglt2 Inhibitors' Diabetic Ketoacidosis Risk

Deepali Dixit, PharmD, BCPS, is a Clinical Assistant Professor at Ernest Mario School of Pharmacy and a Clinical Critical Care Pharmacist in the Medical Intensive Care Unit at Robert Wood Johnson University Hospital. Dr. Dixit has been involved in multiple committees and in leadership positions in regional and national pharmacy and organizations. Dr. Dixit's research interests include sedation and delirium in the critically ill, infectious disease, alcohol withdrawal syndrome, chronic obstructive pulmonary disease, and patient safety. This article was collaboratively written with Shannon Anthony, PharmD Candidate. In May 2015, the FDA issued a warning about the risk of developing diabetic ketoacidosis while using SGLT2 inhibitors. That December, the FDA updated the drugs’ labels to include warnings about developing ketoacidosis even with near-normal blood glucose levels.1 SGLT2 inhibitors lower blood glucose levels by decreasing renal glucose reabsorption, which increases urinary glucose excretion.2 Three drugs in this class are currently available in the United States: canagliflozin (Invokana), dapagliflozin (Farxiga), and empagliflozin (Jardiance).1 These medications are approved for managing type 2 diabetes, although they’re increasingly used off-label to treat type 1 diabetes (T1D), and trials are currently being conducted to evaluate their efficacy for this potential indication.3 Diabetic ketoacidosis (DKA) develops most frequently in T1D patients secondary to omission or decreased dosage of insulin, acute illness, or a recent surgical procedure.4 The typical clinical presentation includes hyperglycemia (>250mg/dL), anion-gap acidosis, and elevated plasma and urine ketones.3 Early diagnosis and management of ketoacidosis is vital. The cornerstone DKA treatment Continue reading >>

Incidence Of Diabetic Ketoacidosis Among Patients With Type 2 Diabetes Mellitus Treated With Sglt2 Inhibitors And Other Antihyperglycemic Agents

Incidence Of Diabetic Ketoacidosis Among Patients With Type 2 Diabetes Mellitus Treated With Sglt2 Inhibitors And Other Antihyperglycemic Agents

Highlights • Overall, unadjusted DKA incidence were similar between SGLT2 and non-SGLT2 agents. • Overall, unadjusted DKA incidence dropped by ∼50% when excluding potential autoimmune diabetes. • Primary analysis found no statistically significant increased risk of DKA with SGLT2 inhibitors. • No increased risk of DKA with SGLT2 inhibitors when excluding potential autoimmune diabetes. • More than half of the DKA cases met the definition of potential autoimmune diabetes. Abstract To estimate and compare incidence of diabetes ketoacidosis (DKA) among patients with type 2 diabetes who are newly treated with SGLT2 inhibitors (SGLT2i) versus non-SGLT2i antihyperglycemic agents (AHAs) in actual clinical practice. A new-user cohort study design using a large insurance claims database in the US. DKA incidence was compared between new users of SGLT2i and new users of non-SGLT2i AHAs pair-matched on exposure propensity scores (EPS) using Cox regression models. Overall, crude incidence rates (95% CI) per 1000 patient-years for DKA were 1.69 (1.22–2.30) and 1.83 (1.58–2.10) among new users of SGLT2i (n = 34,442) and non-SGLT2i AHAs (n = 126,703). These rates more than doubled among patients with prior insulin prescriptions but decreased by more than half in analyses that excluded potential autoimmune diabetes (PAD). The hazard ratio (95% CI) for DKA comparing new users of SGLT2i to new users of non-SGLT2i AHAs was 1.91 (0.94–4.11) (p = 0.09) among the 30,196 EPS-matched pairs overall, and 1.13 (0.43–3.00) (p = 0.81) among the 27,515 EPS-matched pairs that excluded PAD. This was the first observational study that compared DKA risk between new users of SGLT2i and non-SGLT2i AHAs among patients with type 2 diabetes, and overall no statistically significant differen Continue reading >>

Study Mentions Concerns Of Diabetic Ketoacidosis When Starting Sglt2 Inhibitors

Study Mentions Concerns Of Diabetic Ketoacidosis When Starting Sglt2 Inhibitors

Study Mentions Concerns of Diabetic Ketoacidosis When Starting SGLT2 Inhibitors Prior data had indicated that sodium-glucose cotransporter 2 (SGLT2) inhibitors could be linked to diabetic ketoacidosis, a serious complication of diabetes. Prior data had indicated that sodium-glucose cotransporter 2 (SGLT2) inhibitors could be linked to diabetic ketoacidosis, a serious complication of diabetes. The recently published results of a claims analysis seem to confirm the association between initiating SGLT2 inhibitor therapy and experiencing diabetic ketoacidosis. According to a study recently published in the New England Journal of Medicine (NEJM), the FDA issued a warning to patients in May 2015 after case studies showed patients were at higher risk of diabetic ketoacidosis. More recently, a report published in Diabetes Care indicated that rates of diabetic ketoacidosis, while rare, were elevated for patients taking SGLT2 inhibitors to treat type 2 diabetes. Diabetic ketoacidosis, which can be life-threatening, occurs when insulin levels are low, provoking the body to burn fatty acids, which causes the presence of acetic ketone bodies. Meanwhile, SGLT2 inhibitors decrease plasma glucose by blocking the reabsorption of glucose at the proximal tubule, the NEJM study explained. The researchers conducting that study used a large commercial claims database to collect a sample of adults who had initiated therapy with either an SGLT2 inhibitor or a dipeptidyl peptidase 4 (DPP4) inhibitor, another medication for diabetes that has not been linked to diabetic ketoacidosis. They examined the records for evidence of hospitalizations for diabetic ketoacidosis up to 180 days after initiating therapy. Over 50,000 patients were identified in the SGLT2 inhibitor group, who tended to be young Continue reading >>

Jardiance, Invokana, Farxiga, And The Other Sglt2 Inhibitors Might Double The Risk Of Diabetic Ketoacidosis (dka) - Drug Injury Watch

Jardiance, Invokana, Farxiga, And The Other Sglt2 Inhibitors Might Double The Risk Of Diabetic Ketoacidosis (dka) - Drug Injury Watch

Jardiance, Invokana, Farxiga, And The Other SGLT2 Inhibitors Might Double The Risk Of Diabetic Ketoacidosis (DKA) Study Compared Newly Initiated Use Of SGLT2 Inhibitor To New Initiation Of Another Class Of Diabetes Drugs To Assess The DKA Side Effect (Posted by Tom Lamb at DrugInjuryWatch.com ) All of these newer diabetes medicines are part of the Sodium-Glucose Co-Transporter-2 (SGLT2) Inhibitors class of drugs: Invokamet XR (canagliflozin and metformin extended-release) Xigduo XR (dapagliflozin and metformin extended-release) Synjardy (empagliflozin and metformin hydrochloride) Synjardy XR (empagliflozin and metformin hydrochloride) The SGLT2 inhibitor class of diabetes drugs is approved by the FDA for treatment of type 2 diabetes (T2D). A "To the Editor" letter in the June 8, 2017 edition of The New England Journal of Medicine (NEJM), titled " Risk of Diabetic Ketoacidosis after Initiation of an SGLT2 Inhibitor ",is likely causing some concerns among doctors and patients about the safety of Jardiance, Invokana, Farxiga, and the other SGLT2 inhibitors. From the start of that letter we get some introductory information about this drug-safety concern raised for these newer diabetes drugs: Inhibitors of sodiumglucose cotransporter 2 (SGLT2) decrease plasma glucose by blocking the reabsorption of glucose at the proximal tubule. Case reports have suggested that SGLT2 inhibitors may be associated with an increased risk of diabetic ketoacidosis, which led to a warning from the Food and Drug Administration (FDA) in May 2015. The objective of our study was to assess the risk of diabetic ketoacidosis after the initiation of an SGLT2 inhibitor. [footnotes omitted] A June 7, 2017 MedPage Today article, " Study Warns of Diabetic Ketoacidosis With SGLT2 Inhibitors in T2D ",provide Continue reading >>

Sglt2 Inhibitors

Sglt2 Inhibitors

SGLT2 inhibitors are not indicated for treatment of adults with type 1 diabetes mellitus, a metabolic disorder that also is characterized by hyperglycemia. In type 1 diabetics, however, the pancreas produces little to no insulin. Sodium glucose cotransporter-2 (SGLT2) inhibitors are a novel class of antihyperglycemics designed to work against SGLT2, a low-affinity, high-capacity transporter protein found in the kidney’s proximal tubules. The mechanism for SGLT2 inhibitors involves preventing the excretion of urinary glucose by reabsorbing glucose. SGLT2 inhibitors discourage this reuptake of glucose in the kidney. SGLT2 inhibitors are indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus, a metabolic disorder commonly characterized by hyperglycemia (high blood sugar) and inadequate levels of insulin or insulin resistance. Some SGLT2 inhibitors have been linked to side effects ranging from UTIs to kidney problems, amputations, bladder cancer and diabetic ketoacidosis (dka). Using SGLT2 inhibitors for the Treatment of Type 2 Diabetes Generally, SGLT2 inhibitors are taken orally once per day, usually before breakfast. Your doctor will prescribe the strength of the pill and tell you exactly how and when to take it. The dose may be changed if your doctor decides doing so would be more beneficial for you. While taking an SGLT2 inhibitor, your doctor may advise you to check your blood sugar levels in accordance with a particular schedule. Be aware that SGLT2 inhibitors will be likely to cause your urine to test positive for glucose. Your doctor may also order tests to check your blood sugar levels and hemoglobin A1C while taking SGLT2 inhibitors. Your doctor may periodically order these same tests, and possibly other Continue reading >>

Study Warns Of Diabetic Ketoacidosis With Sglt2 Inhibitors In T2d

Study Warns Of Diabetic Ketoacidosis With Sglt2 Inhibitors In T2d

Study Warns of Diabetic Ketoacidosis With SGLT2 Inhibitors in T2D Doubled risk compared with DPP4 inhibitors by Kristen Monaco, Contributing Writer, MedPage Today This article is a collaboration between MedPage Today and: The newest class of drugs for treating type 2 diabetes, SGLT2 inhibitors, carries a greater risk for diabetic ketoacidosis compared to other classes of drugs. Note that although this event is rare -- with an absolute risk at 2.5 per 1,000 person-years of patients off insulin -- the researchers strongly suggest healthcare providers be vigilant for signs and symptoms of this in their patients, and should also be a factor to consider at time of prescription. The newest class of drugs for treating type 2 diabetes carries a greater risk for diabetic ketoacidosis compared to other classes of drugs, a new study suggests. Newly initiated use of an SGLT2 inhibitor was associated with a roughly twofold greater risk of diabetic ketoacidosis versus new initiation of a DPP4 inhibitor (HR 2.2, 95% CI 1.4 to 3.6), according to Michael Fralick, MD, of Brigham and Women's Hospital, and colleagues. Findings were similar in an unadjusted model, while hospitalization for diabetic ketoacidosis (DKA) within 180 days of treatment initiation was around two-times higher with use of an SGLT2 inhibitor compared to a DPP4 inhibitor (4.9 events per 1,000 person-years versus 2.3 events per 1,000 person-years; HR 2.1, 95% CI 1.5 to 2.9). The findings were published as a letter in The New England Journal of Medicine . Following twenty case reports of diabetic ketoacidosis with this class of drugs, the FDA issued a warning in May 2015, and announced required label changes later that year after over 70 cases of ketoacidosis were reported. In June 2016, the American Association of Clin Continue reading >>

Sglt2 Inhibitors May Predispose To Ketoacidosis

Sglt2 Inhibitors May Predispose To Ketoacidosis

SGLT2 Inhibitors May Predispose to Ketoacidosis Diabetes, Endocrinology, and Obesity Branch (S.I.T., J.E.B., K.I.R.), National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland 20892; Division of Diabetes, Endocrinology, and Nutrition (S.I.T.), Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201 Address all correspondence and requests for reprints to: Simeon I. Taylor, MD, PhD, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Mail Stop 1453, 9000 Rockville Pike, Bethesda, MD 20892. Search for other works by this author on: Diabetes, Endocrinology, and Obesity Branch (S.I.T., J.E.B., K.I.R.), National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland 20892; Search for other works by this author on: Diabetes, Endocrinology, and Obesity Branch (S.I.T., J.E.B., K.I.R.), National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland 20892; Search for other works by this author on: The Journal of Clinical Endocrinology & Metabolism, Volume 100, Issue 8, 1 August 2015, Pages 28492852, Simeon I. Taylor, Jenny E. Blau, Kristina I. Rother; SGLT2 Inhibitors May Predispose to Ketoacidosis, The Journal of Clinical Endocrinology & Metabolism, Volume 100, Issue 8, 1 August 2015, Pages 28492852, Sodium glucose cotransporter 2 (SGLT2) inhibitors are antidiabetic drugs that increase urinary excretion of glucose, thereby improving glycemic control and promoting weight loss. Since approval of the first-in-class drug in 2013, data have emerged suggesting that these drugs increase the risk of di Continue reading >>

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