PMID- 37245675
OWN - NLM
STAT- MEDLINE
DCOM- 20230717
LR  - 20231121
IS  - 1878-1780 (Electronic)
IS  - 1262-3636 (Linking)
VI  - 49
IP  - 4
DP  - 2023 Jul
TI  - Use of SGLT2 inhibitors after bariatric/metabolic surgery: Risk/benefit balance.
PG  - 101453
LID - S1262-3636(23)00035-6 [pii]
LID - 10.1016/j.diabet.2023.101453 [doi]
AB  - Bariatric/metabolic surgery and sodium-glucose cotransporter 2 inhibitors 
      (SGLT2is) are becoming increasingly popular for the management of 
      overweight/obese patients with type 2 diabetes mellitus (T2DM). Consequently, the 
      chance that a patient undergoing bariatric/metabolic surgery is also treated with 
      an SGLT2i would be rather common in clinical practice. Both risks and benefits 
      have been reported. On the one hand, several cases of euglycemic diabetic 
      ketoacidosis have been reported within the few days/weeks after 
      bariatric/metabolic surgery. The causes are diverse but a drastic reduction in 
      caloric (carbohydrate) intake most probably plays a crucial role. Thus, SGLT2is 
      should be stopped a few days (and even more if a pre-operative restricted diet is 
      prescribed to reduce liver volume) before the intervention and reintroduced only 
      when the caloric (carbohydrate) intake is sufficient. On the other hand, SGLT2is 
      may exert a favorable effect to reduce the risk of postprandial hypoglycemia, a 
      complication reported among patients who have been treated with 
      bariatric/metabolic surgery. An increased hepatic glucose production and a 
      reduced production of interleukin-1beta have been proposed as possible underlying 
      mechanisms for this protective effect. Finally, whether SGLT2is could prolong 
      diabetes remission following surgery and improve the prognosis of patients with 
      T2DM who benefit from bariatric/metabolic surgery remains to be investigated.
CI  - Copyright (c) 2023. Published by Elsevier Masson SAS.
FAU - Scheen, Andre J
AU  - Scheen AJ
AD  - Division of Clinical Pharmacology, Centre for Interdisciplinary Research on 
      Medicines (CIRM), Liege University, Liege, Belgium; Division of Diabetes, 
      Nutrition and Metabolic Disorders, CHU Liege, Liege, Belgium. Electronic address: 
      andre.scheen@chuliege.be.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230526
PL  - France
TA  - Diabetes Metab
JT  - Diabetes & metabolism
JID - 9607599
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
RN  - IY9XDZ35W2 (Glucose)
RN  - 0 (Carbohydrates)
SB  - IM
MH  - Humans
MH  - *Sodium-Glucose Transporter 2 Inhibitors/therapeutic use
MH  - *Diabetes Mellitus, Type 2/complications/drug therapy/surgery
MH  - *Bariatric Surgery/adverse effects
MH  - Glucose
MH  - Risk Assessment
MH  - Carbohydrates/therapeutic use
OTO - NOTNLM
OT  - Bariatric surgery
OT  - Diabetic ketoacidosis
OT  - Metabolic surgery
OT  - Postprandial hypoglycemia
OT  - SGLT2 inhibitor
OT  - Type 2 diabetes mellitus
COIS- Declaration of Competing Interest None.
EDAT- 2023/05/29 00:42
MHDA- 2023/07/17 06:42
CRDT- 2023/05/28 19:25
PHST- 2023/05/11 00:00 [received]
PHST- 2023/05/13 00:00 [accepted]
PHST- 2023/07/17 06:42 [medline]
PHST- 2023/05/29 00:42 [pubmed]
PHST- 2023/05/28 19:25 [entrez]
AID - S1262-3636(23)00035-6 [pii]
AID - 10.1016/j.diabet.2023.101453 [doi]
PST - ppublish
SO  - Diabetes Metab. 2023 Jul;49(4):101453. doi: 10.1016/j.diabet.2023.101453. Epub 
      2023 May 26.