Sodium-glucose cotransporter 2 (SGLT2) inhibitors

Experts have developed consensus recommendations for minimizing diabetic ketoacidosis risk in patients with type 1 diabetes treated with SGLT inhibitors.

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.

The results of the DECLARE-TIMI 58 trial show a broadly positive effect of dapagliflozin on cardiovascular outcomes, especially heart failure, in patients with type 2 diabetes.

The addition of empagliflozin to insulin therapy reduces glycated hemoglobin levels in patients with type 1 diabetes, indicate findings from the phase III EASE-2 and 3 trials.

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?

Researchers have found evidence to support an increased risk for amputation among patients with type 2 diabetes taking sodium-glucose cotransporter 2 inhibitors relative to some oral treatments.

Patients with type 2 diabetes who are treated with sodium-glucose cotransporter 2 inhibitors have numerically higher rates of amputation than those given dipeptidyl peptidase-4 inhibitors, but the difference does not reach statistical significance, researchers report.

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.

Papadopoulou E et al. J Hum Hypertens 2018. doi: 10.1038/s41371-018-0079-5

Pereira MJ et al. Diabetes Ther 2018. doi: 10.1007/s13300-018-0449-6

Dave N, Wu J, Thomas S. Curr Diab Rep 2018; 18: 44. doi: 10.1007/s11892-018-1010-8

Deng Z et al. Diabetes Ther 2018. doi: 10.1007/s13300-018-0448-7

Specialist physicians and antidiabetic medications reported to confer cardiovascular benefit are being underutilized by patients with type 2 diabetes and cardiovascular disease, US study data show.

Formoso G et al. Acta Diabetol 2018; 55: 759. doi: 10.1007/s00592-018-1134-y

The latest analysis of the CANVAS trial indicates that the cardiovascular benefits of canagliflozin in patients with type 2 diabetes may be greatest in those with concomitant heart failure.

The AWARD-10 findings show significantly improved glycemic control in patients with type 2 diabetes who add the glucagon-like peptide-1 receptor agonist dulaglutide to any sodium-glucose cotransporter 2 inhibitor.

Editorial board member John Wilding casts a critical eye over the positive buzz surrounding the potential uses of sodium-glucose cotransporter 2 inhibitors in type 1 diabetes treatment.

Horikawa Y et al. Diabetes Ther 2018; 9: 421. doi: 10.1007/s13300-018-0369-5

Editorial Board member Sanjay Kalra presents a pragmatic approach to the use of sodium-glucose co-transporter-2 inhibitors in patients affected by acute coronary syndromes.

The authors review potential adverse events related to initiating SGLT2 inhibitors and propose a treatment algorithm for the adjustment of concomitant therapies after initiating therapy.