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Sglt2 Inhibitors And Dka

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Susan Cornell, PharmD, CDE, FAPhA, FAADE, describes the risks for ketoacidosis and serious urinary tract infection associated with use of SGLT2 inhibitors. This video was recorded at APhA's 2016 Annual Meeting and Exposition in Baltimore, Maryland.

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 patien Continue reading >>

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  1. MathWiz

    I wasn’t sure which section I should post this in, my strategy is what I call the 4–2–1 plan, I fast 2 day non consecutive days a week, eat a low carb but not calorie restricted diet 4 days a week to keep the fat burning benefits of ketosis going and then I give myself 1 day a week to indulge and eat whatever I want, usually a Saturday pasta dinner and wonderful dessert. I also walk 4 to 6 miles a day during the week and 10 to 12 miles on Saturday.
    Low Carb plans such as Atkins can be very effective for some people including me, many people who start a low carb diet experience get what’s called the “ketosis flu” or the “induction flu” in the first few days while the body is adapting to burning ketones instead of glucose.
    The basic symptoms are:
    – Headaches
    – Nausea
    – Upset stomach
    – Lack of mental clarity (brain fog)
    – Sleepiness
    – Fatigue
    It’s called the “ketosis flu” for a reason: you feel sick. I’ve gone through it and it wasn’t a pleasant experience. Fortunately it only lasted 2 days but then suddenly I woke up feeling much better, less hungry and my energy level was really high and consistent throughout the day!
    The first time I thought to myself: “What the heck am I doing? I feel like I’m going to die!” but I persevered and when it was over I didn’t regret a thing because what I had gained mentally and physically was 100% worth it.
    For those of you that are going through the ketosis flu, don’t give up! I know you feel like it’s never going to get better but stick with it and you´ll be so happy you did! I’m telling you, waking up refreshed for the first time in years, not getting the afternoon “blah” feeling and stuffing my face with carbs to try to boost my energy is the best side effect of the low carb diet I’ve experienced. Okay, losing weight while eating good food, feeling full and satisfied is great too.
    First you have to understand why your body is reacting this way. Your body’s been burning glucose for energy so it’s basically full of enzymes that are waiting to deal with the carbs you eat, but now the body needs to make new enzymes that burn fat for fuel instead of carbs, and the transition period causes the flu-like symptoms.
    There are some things you can do to lessen the symptoms of the ketosis flu and to make it go away sooner (to force the body to transition sooner) Ok, let’s get to the good part – what to do:
    First of all – you’re probably dehydrated. Drink PLENTY of water while you’re on a low carb diet, and then drink some more.
    Watch your electrolytes. When the body is getting rid of excess insulin from your former carb-crazy diet you´ll lose lots of fluids that have been retained in your body. This causes the rapid weight loss most people see in their first few days of ketosis, it’s mostly water, sorry. When you lose all the retained water you also lose electrolytes like sodium, magnesium and potassium. When you’re lacking them you´ll feel like crap so when you’re feeling really ill on the ketosis flu try things like chicken/beef broth and look for foods rich in these minerals. Take a multi-vitamin and a multi-mineral.
    Ok, here is where people throw the red flag – Eat more fat – Yup, I said MORE fat. Have some butter, just not on a roll, eat some bacon and eggs for breakfast, just skip the potatoes and toast. This will force your body to hurry up the transition. You´ll think this is crazy and think you´ll never get lose weight eating this way, but you will.
    Don’t eat too much protein – The body can transform protein into glucose so if you eat too much of it in the first days it will slow down the transition. Go for fatty meat and cheese if you can, add fat to protein shakes etc.
    Drink water, replenish electrolytes (sodium, magnesium, potassium) with food and supplements, drink broth, eat fat and not too much protein.
    I hope this helps, and have a great day
    Charles

  2. rockyromero

    @mathwiz
    ” Take a multi-vitamin and a multi-mineral.”
    I have been forgetting to take a multi-vitamin on fast days. Thanks for the reminder.
    “Eat more fat – Yup, I said MORE fat. ”
    I will have avocado more often.

  3. AussieJess

    Thanks for that info, very interesting

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SGLT2 inhibitors show no significant risk of DKA, study reports Follow this link: http://tinyurl.com/6irc9o5ia89 SGLT2 inhibitors show no significant risk of DKA, study reports click here full resolution --- for more information go to-http://tinyurl.com/pvwe7iu879/ Adults with type 2 diabetes who take SGLT2 inhibitors are less likely to experience diabetic ketoacidosis (DKA) than those on insulin treatment, a study suggests.These findings existed for those with type 2 diabetes either prescribed SGLT2 inhibitors as a single treatment or in combination with another drug.Scientists from the Steno Diabetes Center, Copenhagen, Denmark examined 415,670 people with type 2 diabetes during 1995-2017, all of whom were treated with medication, including insulin.They sought to evaluate the rates of DKA within patients to assess if any association could be made between DKA, a dangerous short-term complication, and SGLT2 inhibitors.SGLT2 inhibitors work by helping the kidneys to lower blood glucose levels, with excess blood glucose removed through urine. for more information go to-http://tinyurl.com/82d95inail/ type 2 diabetes, SGLT2 inhibitors, dka

New Study Links Sglt2 Inhibitors To Increased Risk Of Diabetic Ketoacidosis

New study links SGLT2 inhibitors to increased risk of diabetic ketoacidosis New study links SGLT2 inhibitors to increased risk of diabetic ketoacidosis Benefits of metformin may involve gut bacteria 23 May 2017 The drug class SGLT2 inhibitors have again been linked with an increased risk of diabetic ketoacidosis (DKA) in a new study. SGLT2 inhibitors have been approved to treat type 2 diabetes in the UK since 2013, but regular links with DKA , a dangerous short-term complication of diabetes if left untreated, have persisted. In 2015 the US Food and Drug Administration (FDA) issued a warning about the drugs' association with DKA, and the Medicines and Healthcare Products Regulatory Agency last year urged healthcare professionals to test for raised ketones in patients with DKA symptoms, even if their blood glucose levels were near normal. In a new study scientists from Brigham and Women's Hospital found that patients treated with SGLT2s are twice as likely to experience DKA compared to another class of diabetes medication . However, the researchers stressed that this risk is still very rare: around one in every 1,000 patients will take an SGLT2 inhibitor will experience DKA. A total Continue reading >>

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Popular Questions

  1. Tresmemphis

    I have a question. Im having a difficult time consuming my 1080 calories a day. Im getting between 600-800. But they are in the percentage of 70-80 percent fat, 15 percent protein and 5 percent carb. My question is due to low calories can I get knocked out of ketosis?

  2. mummydee

    It is What you eat , not how much that puts you into ketosis. Your body will burn sugars first for energy and by removing all sugars in every form your body then moves into using fat for energy.
    If you are on Atkins induction you still must eat 20 net grams of carbs but only from veggies creams and cheeses.
    You will get knocked out of ketosis the moment you eat any sugars.
    If it is a plant, eat it, if it comes from a plant, don't!

  3. k9gold

    If your on induction and on Atkins 20 you should be eating 20 NC with 12-15 of them coming from foundation veggies. You should be having 4 to 6 oz of protein with each of the three meals. The cheese limit is 4oz a day and some people find to lose they need to consume less than 4oz. Calories for women are 1500-1800. The Atkins site has the list of foods for all phases. If you eat to little calories your body goes into starvation mode and holds on to everything. Hope this helps

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CONTINUE WATCHING: https://goo.gl/APNPrA?38813

Sglt2 Inhibitors And Dka In People With Type 1 Diabetes

SGLT2 Inhibitors and DKA in People With Type 1 Diabetes Treating type 1 diabetes with insulin alone can be a challenge. One fairly new class of drugs, SGLT2 inhibitors, appears to be an effective add-on treatment. It reduces blood glucose levels, body weight, and the amount of insulin patients need. Also, it does not increase the frequency ofhypoglycemia(low blood glucose levels) in people with either type 1 or type 2 diabetes. However, the drug may increase the risk of diabetic ketoacidosis (DKA), a dangerous form of extremehyperglycemia(high blood glucose levels) that can lead tocomaor even death. How real is that risk? A total 351 people with poorly controlled type 1 diabetes signed up for the study. All either took multiple daily injections of insulin or used an insulin pump, which continuously delivers insulin under the skin. The participants were randomly assigned to one of two groups for the 18-week study. One group took the study drug canagliflozin, an SGLT2 inhibitor, at 100 or 300 mg once a day. The other group was given a placebo, which resembled the treatment pill but had no active ingredients. The goal: to determine which group had a higher number of participants who Continue reading >>

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Popular Questions

  1. Heather_Bryant

    I have been doing Keto since June 27 this year....so almost a month. I was finally able to get my hands on a bottle or ketone tear strips. Just did my first test tonight and as soon as the stick hit urine it turned super dark purple (darkest shade posssible...box says large amount of ketones and says 160 for the number). I have a few questions...
    1. Is that good? Or is that “too much” ketones??
    2. Is there a certain time of day I should be testing to get the most accurate results?
    3. Does this large amount of ketones mean I’m in a deep state of Ketosis? Maybe even almost fat adapted? (I hope!)
    Thanks for any help!!

  2. Ijjunne

    Keto sticks turning purple means that you're producing and excreting a lot of ketones. Don't worry, it's not too much ketones. If you're not type 1 diabetic or type 2 with pancreatic failure, you should be fine. You seem to be in ketosis, but it doesn't necessarily mean that you're fat adapted. I always test in the morning in a fasted state.

    But I have to warn that the keto sticks are not reliable after a certain time being in ketosis, because the ketones you'll produce will be used and not excreted.

  3. Heather_Bryant

    Thanks!
    No, I’m not diabetic. So I guess this test result is great news! Yay!
    I also heard that once you’re fat adapted you won’t show any ketones on test sticks. Is that correct? That would be one small way to help tell when I am.

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