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SGLT-2 Inhibitors: Is There a Role in Type 1 Diabetes Mellitus Management?
Nabila Ahmed-Sarwar1,2, Angela K Nagel1,2, Samantha Leistman1
11 St John Fisher College, Rochester, NY, USA.
The Annals of Pharmacotherapy
|May 25, 2017
Summary
Sodium-glucose cotransporter 2 (SGLT-2) inhibitors combined with insulin therapy show potential for improving glycemic control in type 1 diabetes mellitus (T1DM). This combination may reduce hemoglobin A1C, insulin dosage, and weight without increasing hypoglycemia risk.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Pharmacology
Background:
- Type 1 diabetes mellitus (T1DM) management requires careful glycemic control.
- Insulin therapy is the cornerstone of T1DM treatment.
- Adjunctive therapies are being explored to improve T1DM outcomes.
Purpose of the Study:
- To review and evaluate the disease management of T1DM patients using sodium-glucose cotransporter 2 (SGLT-2) inhibitors alongside insulin therapy.
- To assess the efficacy and safety of SGLT-2 inhibitors as an adjunct to insulin in T1DM.
Main Methods:
- A comprehensive literature search was conducted using PubMed and Ovid databases.
- Keywords included specific SGLT-2 inhibitors (canagliflozin, empagliflozin, dapagliflozin), T1DM, and insulin.
- English-language articles were reviewed, with bibliographies of relevant manuscripts also examined.
Main Results:
- Combination therapy with SGLT-2 inhibitors and insulin led to reductions in hemoglobin A1C (up to 0.49%) and body weight (up to 2.7 kg).
- Total daily insulin doses were lowered in patients receiving combination therapy.
- A decreased incidence of hypoglycemia was observed with the addition of SGLT-2 inhibitors.
Conclusions:
- SGLT-2 inhibitors may play a role in T1DM management by improving glycemic control when used with insulin.
- The combination therapy demonstrated potential benefits without a significant increase in hypoglycemia risk.
- Further research is needed to fully assess risks like diabetic ketoacidosis and urogenital infections due to study limitations.
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