Diabetes Centre for Children and Adolescents, Kinder- und Jugendkrankenhaus Auf der Bult, Hannover, Germany.
University of Colorado Denver and Barbara Davis Center for Diabetes, Aurora, CO.
Diabetes Care. 2019 Jun;42(6):1147-1154. doi: 10.2337/dc18-2316. Epub 2019 Feb 6.
Sodium-glucose cotransporter (SGLT) inhibitors are new oral antidiabetes medications shown to effectively reduce glycated hemoglobin (A1C) and glycemic variability, blood pressure, and body weight without intrinsic properties to cause hypoglycemia in people with type 1 diabetes. However, recent studies, particularly in individuals with type 1 diabetes, have demonstrated increases in the absolute risk of diabetic ketoacidosis (DKA). Some cases presented with near-normal blood glucose levels or mild hyperglycemia, complicating the recognition/diagnosis of DKA and potentially delaying treatment. Several SGLT inhibitors are currently under review by the U.S. Food and Drug Administration and European regulatory agencies as adjuncts to insulin therapy in people with type 1 diabetes. Strategies must be developed and disseminated to the medical community to mitigate the associated DKA risk. This Consensus Report reviews current data regarding SGLT inhibitor use and provides recommendations to enhance the safety of SGLT inhibitors in people with type 1 diabetes.
钠-葡萄糖共转运蛋白（SGLT）抑制剂是新型的口服抗糖尿病药物，已被证明可有效降低糖化血红蛋白（A1C）和血糖变异性、血压和体重，而不会导致 1 型糖尿病患者发生低血糖。然而，最近的研究，特别是在 1 型糖尿病患者中，已经表明糖尿病酮症酸中毒（DKA）的绝对风险增加。一些病例表现为接近正常的血糖水平或轻度高血糖，这使得 DKA 的识别/诊断变得复杂，并可能导致治疗延迟。目前，美国食品和药物管理局和欧洲监管机构正在对几种 SGLT 抑制剂进行审查，作为 1 型糖尿病患者胰岛素治疗的辅助手段。必须制定并向医疗界传播策略，以减轻相关的 DKA 风险。本共识报告审查了关于 SGLT 抑制剂使用的现有数据，并提出了建议，以提高 1 型糖尿病患者使用 SGLT 抑制剂的安全性。
