Adverse effects

Diabetologist Sanjay Kalra puts the CAROLINA trial into historical context and considers the present-day implications for the use of DPP-4 inhibitors and sulfonylureas.

Fournier gangrene remains very rare, but is more common in people using SGLT2 inhibitors compared with other diabetes medications and has severe consequences, shows research.

Research based on insurance claims data indicates that new users of the sodium-glucose cotransporter-2 inhibitor canagliflozin are no more likely to experience a fracture than new users of glucagon-like peptide-1 receptor agonists.

Data from clinical practice suggest the possibility of an increased relative risk for cholangiocarcinoma among patients taking incretin-based antidiabetes medications, although the absolute risk remains small.

John Wilding considers the real-world studies examining the association between SGLT2 inhibitors and amputation risk in patients with type 2 diabetes.

How many real-world studies have looked at amputation risk in users of SGLT2 inhibitors, and do the findings support or refute the effect found in CANVAS? medwireNews rounds up the research so far.

A registry study in The BMJ finds a small but significant increased risk for amputations in patients with type 2 diabetes using sodium-glucose cotransporter 2 inhibitors.

Tosur M, Redondo MJ, Lyons SK. Curr Diab Rep 2018; 18: 79. doi: 10.1007/s11892-018-1041-1

Dave CV et al. Diabetes Obes Metab 2018. doi: 10.1111/dom.13531

Leiter LA et al. Diabet Med 2018. doi: 10.1111/dme.13817

Advisory Board member Theresa Smyth tackles an emergency case in a type 2 diabetes patient treated with empagliflozin. What went wrong and how should he be managed?

Bundhun PK, Huang F. Diabetes Ther 2018. doi: 10.1007/s13300-018-0481-6

Researchers have used data from clinical practice and randomized trials to identify simple predictors of patient response to sulfonylureas and thiazolidinediones.

Patients with type 2 diabetes who are treated with semaglutide experience greater improvements in glycemic control than those given liraglutide, but at the cost of a higher risk for gastrointestinal adverse events, researchers report.

Wilding J et al. Diabetes Ther 2018. doi: 10.1007/s13300-018-0471-8

Carmen Soto and David Strain provide their insights on clinical inertia in diabetes care and present the co-production model of open communication as an innovative means to address this widespread clinical issue.

A European-wide case–control study finds little evidence for risk to the developing fetus if a mother is taking metformin.

A study of patients from US administrative claims databases finds no evidence that use of canagliflozin increases the risk for below the knee amputation when compared with other sodium-glucose cotransporter 2 inhibitors or with other antidiabetic medications.

The DEPICT-1 and inTandem1 investigators have released their 52-week findings, revealing persistent reductions in glycated hemoglobin with SGLT2 inhibition, but a slightly increased risk for diabetic ketoacidosis.

Mathieu C et al. Diabetes Ther 2018. doi: 10.1007/s13300-018-0445-x