Sglt2 Ketosis

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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.

Auctores | Article In Press | Review Article: Sglt2 Inhibitors And Ketoacidosis: Epidemiology And Pathophysiology

Review Article: SGLT2 Inhibitors And Ketoacidosis: Epidemiology And Pathophysiology Review Article: SGLT2 Inhibitors And Ketoacidosis: Epidemiology And Pathophysiology Broadlawns Medical Center, Des Moines, University of Iowa. Corresponding author: Udaya M Kabadi, Broadlawns Medical Center, Des Moines, University of Iowa. E-mail: [email protected] , Phone: 3195948575 SGLT 2 inhibitors are a recent addition to the armamentarium of agents approved for treatment of hyperglycemia in management of type 2 diabetes. Unfortunately, the agents are fairly expensive with a modest efficacy rendering them to be probably the least cost effective drugs in management of hyperglycemia in subjects with type 2 diabetics. The cost efficacy falls even more because of additional expenses required for management of several short term and long term adverse outcomes causing a decline in quality of life. Ketosis and ketoacidosis are two of the several cautions issued by regulatory agencies and have gained prominence because of their serious nature with an occasional fatality. In this review, epidemiology and pathophysiology of onset of ketoacidosis in subjects administered SGLT2 inhibitors is discussed in Continue reading >>

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Popular Questions

  1. itsryanneyo

    So after a month of horrible stomach pains, I finally went to see my alternative medicine doctor. My gallbladder is sludgy and full of pebbles, and she's put me on a pretty good dose of hydrangea root to break up the stones and hi-lipase to get everything flushed out of my g.b... I've read so many different versions of what causes this--eating high fat / eating low fat / eating low fat and then going to high fat. I'm not too terribly wrapped up in what caused it, but rather getting it taken care of. I still battle the constipation that everyone else seems to get past after the first 4 weeks, and I'm sure that this has contributed to my g.b. issues. Anyone else had to deal with this? My results and every other aspect of my well-being are so great, I can't fathom not being on a LC lifestyle. I love my bulletproof coffee, but even sometimes just a few sips is now sending my gut into the ultimate knot. I haven't let this issue keep me from working out, still going strong 6 days a week, but not sure how much longer I'm gonna be able to keep that up...
    Any words of advice would be greatly appreciated!

  2. ejdp254

    Sorry no answer for you, my gall stones acted up after about 5 month's, absolute agony, I can eat normally now but my gall bladder is also full of sludge and stones so waiting for my Dr to suggest a solution - hopefully without surgery! That said I already had gall stones so I doubt if 5 months LCHF made that much difference and I hope to continue eating this way

  3. itsryanneyo

    Our stories sound so similar! I was 5 months in when my gut started hurting, as well... I did read that if you ate low carb and/or high protein that makes them develop, and then act up when you start loading up on fats. Not sure about you, but that's definitely my story... I was really big into low fat, high protein prior to keto. Please let me know if you have any luck, I'm open to suggestions...

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Ketosis And Diabetic Ketoacidosis In Response To Sglt2 Inhibitors: Basic Mechanisms And Therapeutic Perspectives

Probing SGLT2 as a therapeutic target for diabetes: Basic physiology and consequences The mechanisms and therapeutic potential of SGLT2 inhibitors in diabetes mellitus Lowering Plasma Glucose Concentration by Inhibiting Renal SodiumGlucose CoTransport SGLT2 inhibitors in the treatment of type 2 diabetes Pharmacodynamics, efficacy and safety of sodiumglucose cotransporter type 2 (SGLT2) inhibitors for the treatment of type 2 diabetes mellitus Renal hemodynamic effect of sodiumglucose cotransporter 2 inhibition in patients with type 1 diabetes mellitus Sodiumglucose cotransporter 2 inhibition and glycemic control in type 1 diabetes: Results of an 8week openlabel proofofconcept trial SGLT2 inhibitors may predispose to ketoacidosis Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes Empagliflozin and progression of kidney disease in type 2 diabetes Physiological roles of ketone bodies as substrates and signals in mammalian tissues Fukao, T; Mitchell, G; Sass, JO; Hori, T; Orii, K; Aoyama, Y Ketone bodies: a review of physiology, pathophysiology and application of monitoring to diabetes A focused review of the role of ketone bodies in health and disease Transport o Continue reading >>

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  1. Abrane

    So finally home from Italy and didn't really pay attention to food or what have you. One thing I do know is my metabolism has slowed from when I had it running high octane of 3200+ calories a day. It took a year of buildup and I'm going to start that again. Hopefully it doesn't take a year again, but you can't rush repairs. So what I'll do is make week to week notes of average daily intake with macros alongside weekly amounts which are the important numbers. I'll track water as well as weight. I know the scale isn't the best measure, but I also know tracking by the week I can get a better picture of what's happening.

    My supposed BMR is roughly 2400cal a day which is 16,800cal for the week. I'll be aiming to hit 17kcal in total and see weight change. As of this morning I am 179.4lbs. My goal? I would like to be 160-164lbs, but my ultimate goal is to be able to eat 3400+ on average. Why? I remember how I felt eating so much and it was a new level for me. My energy levels, sex life, strength and mental drive we're on point and I'd like it back. I will fast from time to time, though more out of response to food rather than desire. If I fail to feel hungry then I won't eat, but i know I'll need to add food to hit my numbers eventually until I adapt.

  2. trekkin1

    Sorry, not following you.
    CICO doesn't work as advertised.

  3. wildbohr

    Timely post, I just finished listening to the latest 2kd which is about metabolism. If you haven't listened check it out you might be able to accelerate your high burn.

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In this segment, Zachary Bloomgarden, MD; Robert Gabbay, MD, PhD, FACP; Silvio Inzucchi, MD; Dennis P. Scanlon, PhD; and Kenneth Snow, MD, MBA, discuss sodium-glucose co-transporter 2 inhibition in patients with diabetes and corresponding outcomes on cardiovascular events.

Sglt2 Inhibition And Ketoacidosis Should We Be Concerned? | Panicker Rajeev | British Journal Of Diabetes

SGLT2 inhibition and ketoacidosis should we be concerned? Obesity and Endocrinology Research Group, Institute of Ageing and Chronic Disease, University of Liverpool Address for correspondence: Professor John PH Wilding Obesity and Endocrinology Research Group, University of Liverpool, Clinical Sciences Centre, Aintree University Hospital NHS Foundation Trust, SGLT2 inhibitors represent a novel class of oral glucose- lowering treatment that addresses some important unmet clinical needs in the treatment of type 2 diabetes, specifically weight reduction and a low propensity to cause hypoglycaemia. SGLT2 inhibition lowers the renal threshold for glucose excretion, resulting in renal glycosuria, a shift in substrate utilisation from carbohydrate to fat oxidation and hyperglucagonaemia; this poses a theoretical risk for ketoacidosis (including euglycaemic ketoacidosis) in the presence of other precipitating factors, especially reduction in insulin doses or low carbohydrate intake. There have been reports of several cases of ketoacidosis, mostly euglycaemic, and in people with type 1 or type 2 diabetes. Subsequent to this there were warnings from regulatory bodies (FDA and EMEA). In this Continue reading >>

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Popular Questions

  1. CharleneRed

    Sick child with normal blood sugar but ketones in urine?

    My 5yr old has type 1, and has the flu. Her blood sugar is pretty normal to sometimes low as she does not want to eat but is drinking fluids. I tested her urine for ketones and they are 2+. I was told to increase her bg and give insulin every hour. does this make any sense?

  2. foxl

    2+ seems high. Ketones can simply indicate that you are burning fat as fuel -- either your own or dietary.
    My non-D daughter, now 10, used to get horrible ketone breath because when ill, she would NOT EAT!
    But GIVE INSULIN every HOUR??? No.

  3. furball64801

    I would not think insulin every hour could be regulated and you would have the stacking affect, make sure she has plenty of fluid.

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