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Harnessing the Synergy of SGLT2 Inhibitors and Continuous Ketone Monitoring (CKM) in Managing Heart Failure among

Nicola Tecce1, Giorgio de Alteriis2, Giulia de Alteriis1

  • 1Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Napoli, Italy.

Healthcare (Basel, Switzerland)
|April 13, 2024
PubMed

Insights

Sodium-glucose cotransporter-2 inhibitors (SGLT2-is) show promise for heart failure (HF) in type 1 diabetes (T1D). Continuous ketone monitoring (CKM) can mitigate the risk of diabetic ketoacidosis (DKA), enabling safer SGLT2-is use.

Area of Science:

  • Cardiology
  • Endocrinology
  • Metabolic Disorders

Background:

  • Heart failure (HF) presents unique challenges in type 1 diabetes (T1D) due to increased prevalence and mortality risks.
  • Diabetic cardiomyopathy is a significant driver of HF in T1D patients.
  • Sodium-glucose cotransporter-2 inhibitors (SGLT2-is) are effective for HF with preserved ejection fraction, common in T1D, but carry a risk of euglycemic diabetic ketoacidosis (DKA).

Purpose of the Study:

  • To investigate the efficacy of SGLT2-is in managing HF within the T1D population.
  • To explore the role of Continuous Ketone Monitoring (CKM) technology in mitigating DKA risk associated with SGLT2-is therapy.
  • To assess the combined potential of SGLT2-is and CKM for improving cardiovascular outcomes and patient safety in T1D.

Main Methods:

  • Comprehensive review of clinical trials, observational studies, and existing literature on SGLT2-is and HF in T1D.
  • Analysis of data regarding the incidence of DKA in T1D patients using SGLT2-is.
  • Evaluation of the capabilities and potential application of CKM technology for real-time ketone level monitoring.

Main Results:

  • SGLT2-is demonstrate significant reductions in HF hospitalizations and improvements in cardiovascular outcomes.
  • The risk of DKA remains a limiting factor for SGLT2-is use in T1D patients.
  • CKM technology offers real-time ketone monitoring, facilitating early detection and management of ketosis.

Conclusions:

  • The combination of SGLT2-is and CKM presents a promising strategy to enhance HF management in T1D.
  • This integrated approach has the potential to improve patient safety, quality of life, and reduce HF-related morbidity and mortality.
  • Further clinical trials are warranted to validate the efficacy and safety of this combined therapeutic strategy.

Keywords:
HFpEFHFrEFSGLT2-icontinuous monitoring of ketone levelsdiabetic cardiomyopathydiabetic ketoacidosisepidemiologic studiesheart failurehospitalizationketonemiapatient educationsodium–glucose cotransporter-2 inhibitorstype 1 diabetes

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