Canagliflozin use in Type I diabetes mellitus

Peters et al documented the appearance of diabetic ketoacidosis without significant elevation of serum glucose in patients treated with Canagliflozin. They solicited patient reports from their practice and from other colleagues' practices and identified nine patients, mainly with Type I Diabetes. Erondu et al evaluated the Canagliflozin development data base to describe the rate and appearance of ketoacidosis in the study patients. They found that in the research patients with Type 2 Diabetes, the rate of ketoacidosis in Canagliflozin patients was uncommon and similar to the reported rate in Type 2 patients not receiving Canagliflozin. Finally, Henry et al reported on a research program that added Canagliflozin onto insulin therapy in Type I patients, finding that there were only modest improvements in HgBA1 C levels and weight, while this therapy produced increased levels of ketosis and 6% rate of ketoacidosis in Canagliflozin patients. This information strongly suggests that Canagliflozin, and possibly the other SGLT-2 inhibitors, are not proper therapy for patients with Type I Diabetes.