PMID- 34819409
OWN - NLM
STAT- MEDLINE
DCOM- 20220603
LR  - 20221207
IS  - 1348-4540 (Electronic)
IS  - 0918-8959 (Linking)
VI  - 69
IP  - 5
DP  - 2022 May 30
TI  - Do the benefits of sodium-glucose cotransporter 2 inhibitors exceed the risks in 
      patients with type 1 diabetes?
PG  - 495-509
LID - 10.1507/endocrj.EJ21-0573 [doi]
AB  - Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are well-established means of 
      improving glycemia and preventing cardio-renal events in patients with type 2 
      diabetes. However, their efficacy and safety have yet to be fully characterized 
      in patients with type 1 diabetes (T1D). We studied patients with T1D who 
      regularly attended one of five diabetes centers and treated with an SGLT2i 
      (ipragliflozin or dapagliflozin) for >52 weeks, and the changes in HbA1c, body 
      mass, insulin dose, and laboratory data were retrospectively evaluated and 
      adverse events (AEs) recorded during December 2018 to April 2021. A total of 216 
      patients with T1D were enrolled during the period. Of these, 42 were excluded 
      owing to short treatment periods and 15 discontinued their SGLT2i. The mean 
      changes in glycated hemoglobin (HbA1c), body mass, and insulin dose were -0.4%, 
      -2.1 kg, and -9.0%, respectively. The change in HbA1c was closely associated with 
      the baseline HbA1c (p < 0.001), but not with the baseline body mass or renal 
      function. The basal and bolus insulin doses decreased by 18.2% and 12.6%, 
      respectively, in participants with a baseline HbA1c <8%. The most frequent AE was 
      genital infection (2.8%), followed by diabetic ketoacidosis (DKA; 1.4%). None of 
      the participants experienced severe hypoglycemic events. In conclusion, the 
      administration of an SGLT2i in addition to intensive insulin treatment in 
      patients with T1D improves glycemic control and body mass, without increasing the 
      incidence of hypoglycemia or DKA.
FAU - Kamoshima, Hikaru
AU  - Kamoshima H
AD  - Yuri Ono Clinic, Diabetes, Internal Medicine, Sapporo 060-0001, Japan.
FAU - Nomoto, Hiroshi
AU  - Nomoto H
AD  - Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and 
      Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.
FAU - Yamashita, Kumiko
AU  - Yamashita K
AD  - Kurihara Clinic, Sapporo 004-0053, Japan.
FAU - Takahashi, Yuka
AU  - Takahashi Y
AD  - Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and 
      Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.
FAU - Tsuchida, Kazuhisa
AU  - Tsuchida K
AD  - Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and 
      Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.
FAU - Kuwabara, Saki
AU  - Kuwabara S
AD  - Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and 
      Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.
FAU - Miya, Aika
AU  - Miya A
AD  - Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and 
      Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.
FAU - Cho, Kyu Yong
AU  - Cho KY
AD  - Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and 
      Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.
FAU - Kameda, Hiraku
AU  - Kameda H
AD  - Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and 
      Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.
FAU - Nakamura, Akinobu
AU  - Nakamura A
AD  - Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and 
      Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.
FAU - Atsumi, Tatsuya
AU  - Atsumi T
AD  - Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and 
      Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.
FAU - Taneda, Shinji
AU  - Taneda S
AD  - Diabetes Center, Manda Memorial Hospital, Sapporo 060-0062, Japan.
FAU - Kurihara, Yoshio
AU  - Kurihara Y
AD  - Kurihara Clinic, Sapporo 004-0053, Japan.
FAU - Aoki, Shin
AU  - Aoki S
AD  - Aoki Clinic, Sapporo 003-0023, Japan.
FAU - Ono, Yuri
AU  - Ono Y
AD  - Yuri Ono Clinic, Diabetes, Internal Medicine, Sapporo 060-0001, Japan.
FAU - Miyoshi, Hideaki
AU  - Miyoshi H
AD  - Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and 
      Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.
AD  - Division of Diabetes and Obesity, Faculty of Medicine and Graduate School of 
      Medicine, Hokkaido University, Sapporo 060-8638, Japan.
LA  - eng
PT  - Journal Article
DEP - 20211125
PL  - Japan
TA  - Endocr J
JT  - Endocrine journal
JID - 9313485
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
RN  - 9NEZ333N27 (Sodium)
SB  - IM
MH  - Blood Glucose
MH  - *Diabetes Mellitus, Type 1/chemically induced/drug therapy
MH  - *Diabetes Mellitus, Type 2/drug therapy
MH  - *Diabetic Ketoacidosis/chemically induced/epidemiology/prevention & control
MH  - Glycated Hemoglobin/analysis
MH  - Humans
MH  - Hypoglycemic Agents/adverse effects
MH  - Insulin/therapeutic use
MH  - Retrospective Studies
MH  - Sodium
MH  - *Sodium-Glucose Transporter 2 Inhibitors/adverse effects
OTO - NOTNLM
OT  - Diabetic ketoacidosis
OT  - Sodium-glucose cotransporter 2 inhibitor
OT  - Type 1 diabetes
EDAT- 2021/11/26 06:00
MHDA- 2022/06/07 06:00
CRDT- 2021/11/25 05:49
PHST- 2021/11/26 06:00 [pubmed]
PHST- 2022/06/07 06:00 [medline]
PHST- 2021/11/25 05:49 [entrez]
AID - 10.1507/endocrj.EJ21-0573 [doi]
PST - ppublish
SO  - Endocr J. 2022 May 30;69(5):495-509. doi: 10.1507/endocrj.EJ21-0573. Epub 2021 
      Nov 25.