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SGLT-2 inhibitors as adjunctive to insulin therapy in type 1 diabetes
, 1, 1
Affiliations- Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Poland
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Abstract
The absolute insulin deficiency that occurs in type 1 diabetes mellitus (T1DM) is associated with the need for intensive functional insulin therapy as the only appropriate treatment model. In the recent years, introduction of new classes of glucose-lowering drugs has led to an increasing interest in adjunct therapies for T1DM. These therapies are designed to support exogenous insulin therapy in achieving the therapeutic goal while reducing the risk of hypoglycaemia and exerting a beneficial effect on body weight. One potential therapeutic option are sodium-glucose co-transporter 2 (SGLT-2) inhibitors. In the present paper, we reviewed the current clinical research on SGLT-2 inhibitors as add-on therapy to insulin in patients with T1DM. This therapy modification contributes to an improvement in metabolic control without increasing the risk of severe hypoglycaemia and with a beneficial effect on body weight, translating to improved compliance, quality of life, and patient satisfaction with treatment. However, due to possible adverse effects including euglycaemic diabetic ketoacidosis, the decision to use SGLT-2 inhibitors in patients with T1DM should be made with caution, and patients require proper education regarding the prevention and treatment of acidosis.
Abstract
The absolute insulin deficiency that occurs in type 1 diabetes mellitus (T1DM) is associated with the need for intensive functional insulin therapy as the only appropriate treatment model. In the recent years, introduction of new classes of glucose-lowering drugs has led to an increasing interest in adjunct therapies for T1DM. These therapies are designed to support exogenous insulin therapy in achieving the therapeutic goal while reducing the risk of hypoglycaemia and exerting a beneficial effect on body weight. One potential therapeutic option are sodium-glucose co-transporter 2 (SGLT-2) inhibitors. In the present paper, we reviewed the current clinical research on SGLT-2 inhibitors as add-on therapy to insulin in patients with T1DM. This therapy modification contributes to an improvement in metabolic control without increasing the risk of severe hypoglycaemia and with a beneficial effect on body weight, translating to improved compliance, quality of life, and patient satisfaction with treatment. However, due to possible adverse effects including euglycaemic diabetic ketoacidosis, the decision to use SGLT-2 inhibitors in patients with T1DM should be made with caution, and patients require proper education regarding the prevention and treatment of acidosis.
Keywords
type 1 diabetes, adjunct therapy, SGLT-2 inhibitors
About this articleTitle
SGLT-2 inhibitors as adjunctive to insulin therapy in type 1 diabetes
Journal
Issue
Article type
Review article
Pages
189-192
Page views
949
Article views/downloads
603
DOI
Bibliographic record
CD 2020;9(3):189-192.
Keywords
type 1 diabetes
adjunct therapy
SGLT-2 inhibitors
Authors
Anna Maj-Podsiadło
Edyta Cichocka
Janusz Gumprecht