diabetestalk.net

Sglt2 Inhibitors For Type 1 Diabetes

Share on facebook

Sglt2 Inhibitors In Type 1 Diabetes

Alyson P. Lozicki, PharmD; Nicholas D. Franz, PharmD Candidate Are SGLT2 inhibitors safe and effective in patients with type 1 diabetes? Drug Information Research Fellow, Creighton University, Omaha, Nebraska Creighton University School of Pharmacy and Health Professions, Omaha, Nebraska Type 1 diabetes (T1D) is caused by the autoimmune destruction of insulin-producing islet cells in the pancreas, resulting in an absolute deficiency of insulin. Treatment requires the exogenous replacement of insulin. This etiology differs from type 2 diabetes (T2D), which is primarily characterized by insulin resistance, and treatment focuses on enhancing insulin sensitivity and lowering blood glucose.[ 1 ] Current guidelines from the American Diabetes Association (ADA) support an intensive insulin regimen for T1D, citing the Diabetes Control and Complications Trial, which demonstrated improvements in vascular and all-cause mortality outcomes with such a regimen. The benefits are clear; however, the multiple injections and adverse effects of insulin compound the burden of disease. Weight gain and the risk for hypoglycemia are most concerning and can cause increased comorbidities and poor complianc Continue reading >>

Share on facebook

Popular Questions

  1. Jiggy Puff

    A couple of years ago I lost 90 lbs. on Atkins. During that time I periodically tested my urine for ketones. Since I was on a very low carb ketogenic WOE you would think I would see my fat loss revealed on the strips. But never did I ever see anything other than just "trace" on the strips, which is barely any. But yet I kept buying the strips. Why? During that time I thought maybe something would show,but no.
    Fast forward to present day. life happened, regained my weight, and restart 2 months ago. I am doing great lost 22 lbs and regret ever leaving this WOE. But with that said, what do I do but go to the store and buy Ketone test strips:? :/ Why? you ask lol. I really don't know, I guess i thought by some miracle of events I would see some different results. Guess what I have been seeing? Yep you guessed it...."trace".
    Now why am I telling you this? It is because it is to show you that not all of us that lose weight and do great on this WOE will show it on our test strips. The ketones that are not showing up on my urine strips are probably being used by my body. Not to mention if you are someone who drinks lots of water, the urine can be diluted and therefore not show much on the strips. Another theory is some of us urinate more times than others; which for those, the ketones don't have time to build up in consistency to show on the strips.
    So don't be discouraged if you don't see anything on your strips you can tell by how well you are doing, by how well you look and feel and the weight loss you obtain by living and eating the best WOE in the world.
    And for those of you who get to enjoy the "colorful" results of moderate results on your strips; it is a pretty why to observe your progress, that is about it. So "stripping or not" lol good luck and happy success my friends.

  2. black57

    It is better to see nothing on the test strips. By seeing nothing on the test strips, your body is telling you that it is indeed using the ketones for energy which is what you want...you don't want to see ketones on the test strips at all. Ketones do not get stored as fat, they're used to maintain bone, muscle and other tissues including heart and brain.When your body uses ketones for energy your body has become ketone adapted and healthier than ever before.

  3. CMCM

    Quote:

    Originally Posted by black57
    It is better to see nothing on the test strips. By seeing nothing on the test strips, your body is telling you that it is indeed using the ketones for energy which is what you want...you don't want to see ketones on the test strips at all. Ketones do not get stored as fat, they're used to maintain bone, muscle and other tissues including heart and brain.When your body uses ketones for energy your body has become ketone adapted and healthier than ever before.
    Good good points. I've rarely if ever seen much on ketostix. Perhaps way back when I first did Atkins, but since I'm always eating pretty much along Atkins low carb lines anyway, whenever I tighten up my eating and go very low carb, the ketostix will show virtually no change.

  4. -> Continue reading
read more
Share on facebook

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

Sglt2-inhibitors In Type 1 Diabetes: Dka Risk Can Be Different Between Agents

SGLT2-inhibitors in type 1 diabetes: DKA risk can be different between agents Current therapeutic options for treating type 1 diabetes (T1DM) remain very limited, with insulin being the mainstay of therapy. However, the data presented at the European Association for the Study of Diabetes (EASD) 2017 Annual Meeting have revealed that selective sodium-glucose co-transporter 2 (SGLT2) inhibitors in addition to daily insulin may bring additional glycemic control and weight loss, albeit with a varying risk of diabetic ketoacidosis (DKA).1,2 One of the promising approaches being investigated to treat T1DM is to add an adjunct agent on top of insulin therapy, to further control the blood glucose without increasing the risk of hypoglycemia, weight gain, and DKA (which is more common in T1DM).3 Owing to the insulin-independent mechanism of action of SGLT2-inhibitors, several clinical trials have been conducted to examine their adjunct use in treating T1DM patients, two of which (DEPICT-1 and InTandem3) showed that SGLT2-inhibitors are an effective adjunct for inadequately controlled T1DM.4,5 DEPICT-1: Promising outcomes with dapagliflozin in T1DM patients DEPICT-1 was a phase 3, double-bli Continue reading >>

Share on facebook

Popular Questions

  1. bulldog

    any good resource on what IV fluids to select?
    i.e. seems like u can us NS for most patients who come in looking dehydrated.
    -if they're NPO, then I've seen D51/2NS or D5NS used. what's the difference between the two in terms of the Na content?
    thanks.

  2. mlw03

    you seem to have the basic gist of it. 1/2 normal saline means that the concentration of Na and Cl is half that of normal saline, so the overall solution is hypotonic instead of isotonic. so i think NS has 154 mEq of Na, while 1/2 NS would then have 77.
    as to the logic, i'm not sure why you switch to 1/2 NS for maintanence (or 1/4 NS for kids < 10kg), but i know that for dehydration you want something isotonic like NS (or LR) because the goal is to increase INTRAVASCULAR volume quickly, and isotonic solutions are the safest, most economical way to do this.

  3. proman

    There's no one ideal fluid for every situation. For resuscitation, crystalloids allow rapid repletion of volume. 0.9% sodium chloride is slightly hypertonic compared to plasma (308 mOsm/L vs 290). Lactated Ringer's is slightly hypotonic (273 vs 290). Since they are both so close to plasma, they are considered the isotonic fluids. You can get a hyperchloremic metabolic acidosis from large volumes of 0.9% NaCl (typically 5+liters). You can get hyponatremic from large volumes of LR. Either are acceptable for volume resuscitation.
    For maintenance, sodium content and tonicity matters. I personally think that maintenance fluids for most patients is overutilized. If you use 0.9% NaCl for an extended amount of time, the plasma sodium content will increase and you may get hypernatremic. To avoid this, solutions like 0.45% or lower are used. If the patient is not eating, and you are concerned about providing calories to prevent protein breakdown, dextrose is added to the fluid. 3 liters of a 5% dextrose solution provides 500 kcal a day enough to be protein sparing. Adding D5 to NS results in a hypertonic solution (560 mOsm/L). If the patient's glucose metabolism is impaired, you could cause cellular dehydration from the hypertonic solution. D5 0.45% NaCl avoid this.
    Really consider the consequences of fluids. If they don't need salt or water, chances are they don't need any fluid. NPO isn't an indication (we all sleep at night without IVs going).
    Does that answer your question?

  4. -> Continue reading
read more
Share on facebook

Effects of Sotagliflozin Added to Insulin in Patients with Type 1 Diabetes In most patients with type 1 diabetes, adequate glycemic control is not achieved with insulin therapy alone. We evaluated the safety and efficacy of sotagliflozin, an oral inhibitor of sodiumglucose cotransporters 1 and 2, in combination with insulin treatment in patients with type 1 diabetes. https://www.youtube.com/channel/UCsqm...

Effects Of Sotagliflozin Added To Insulin In Patients With Type 1 Diabetes

In most patients with type 1 diabetes, adequate glycemic control is not achieved with insulin therapy alone. We evaluated the safety and efficacy of sotagliflozin, an oral inhibitor of sodium–glucose cotransporters 1 and 2, in combination with insulin treatment in patients with type 1 diabetes. In this phase 3, double-blind trial, which was conducted at 133 centers worldwide, we randomly assigned 1402 patients with type 1 diabetes who were receiving treatment with any insulin therapy (pump or injections) to receive sotagliflozin (400 mg per day) or placebo for 24 weeks. The primary end point was a glycated hemoglobin level lower than 7.0% at week 24, with no episodes of severe hypoglycemia or diabetic ketoacidosis after randomization. Secondary end points included the change from baseline in glycated hemoglobin level, weight, systolic blood pressure, and mean daily bolus dose of insulin. A significantly larger proportion of patients in the sotagliflozin group than in the placebo group achieved the primary end point (200 of 699 patients [28.6%] vs. 107 of 703 [15.2%], P<0.001). The least-squares mean change from baseline was significantly greater in the sotagliflozin group than in Continue reading >>

Share on facebook

Popular Questions

  1. BabyJJ

    Active Low-Carber Forums

    Hi, i was thinking of starting a thread for pp from Singapore who's on Atkins so tat we can exchange ideas abt wat food is permissible while eating out and on induction and where to find LC products, ketostix here and so on.. :)

  2. Juliegilla

    Hi BabyJJ
    This is the first time I've posted on this board, although I've been reading it for a while.
    I started Atkins 3 weeks ago, and thought was the only one in Singapore trying to follow it!
    I'm British but have been working here in Singapore for about a year now.
    I find eating out in the food courts here a bit of trial - I tend to just buy 2 meals (because it's quite cheap) and discard the rice/noodles element of each.
    Would certainly be interested hearing about any ideas you've got for a support group.

  3. sweetjane

    Hello!
    Me Singaporean now livign in japan. I'm going back to SG in Jan 2003 & i'm wondering if they sell low carb products in the healthstores now in sg?
    Kelly

  4. -> Continue reading
read more

No more pages to load

Related Articles

  • Sglt2 Inhibitors And Diabetes

    These medications typically lower HbA1c levels by 0.5 1% after about 6 months of therapy. Some patients report mild weight loss after taking SGLT2 inhibitors. SGLT2 inhibitors may increase urination and raise the risk of female yeast infections and urinary tract infections. These drugs can also lead to low blood pressure . Kidney function needs to be tested before and during treatment with SGLT2 inhibitors Persons with severe kidney disease or o ...

    diabetes Feb 4, 2018
  • Sglt2 Inhibitors And Dka

    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 ...

    ketosis Apr 2, 2018
  • Sglt2 Inhibitors Acidosis

    Retrospective review of SGLT2 inhibitor exposures reported to 13 poison centers. Scott E Schaeffer, Carol DesLauriers, Henry A Spiller, Alfred Aleguas, Salvador Baeza, Mark L Ryan BACKGROUND: SGLT2 inhibitors are a new class of oral antidiabetics prescribed in the United States since 2013. They act by inhibiting reabsorption of glucose in the proximal convoluted tubule of the kidney, allowing excess glucose to be excreted. Little has been report ...

    ketosis Apr 27, 2018
  • Sglt2 Inhibitors Ketoacidosis Mechanism

    J Clin Endocrinol Metab. 2015 Aug;100(8):2849-52. doi: 10.1210/jc.2015-1884. Epub 2015 Jun 18. 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; and Division of Diabetes, Endocrinology, and Nutrition (S.I.T.), Department of Medicine, University of Maryland ...

    ketosis Jan 21, 2019
  • Sglt2 Inhibitors Diabetes Care

    Euglycemic diabetic ketoacidosis is a post market warning in patients with type 1 diabetes and type 2 diabetes treated with SGLT-2 inhibitors. We report a case of a 39-year-old obese female with presumed type 2 diabetes for seven years who presented to the emergency department with three days of nausea, vomiting, and abdominal pain. Due to previous total non-adherence with a prescribed insulin regimen, she was recently started on canagliflozin an ...

    ketosis May 5, 2018
  • Sglt2 Inhibitors For Type 1 Diabetes

    Meta-analysis explores safety and efficacy of sodium-glucose co-transporter 2 inhibitors in patients with type 1 diabetes. Individuals living with type 1 diabetes most of their lives are exposed to numerous comorbidities that ultimately lead to a significant decrease in estimated life expectancy by approximately 12 years, as we have seen with former studies conducted on the subject. Moreover, considering that patients with type 1 are treated wit ...

    ketosis May 5, 2018

More in ketosis