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In insulin-treated type 1 diabetes, canagliflozin increased diabetic ketoacidosis

Ann Intern Med. 2016;165(2):JC2. doi:10.7326/ACPJC-2016-165-2-002
© 2016 American College of Physicians
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SGLT-2 receptor inhibitors should better be avoided in patients with type 1 diabetes
Posted on July 21, 2016
Gauranga Dhar
Bangladesh Institute of Family Medicine and Research
Conflict of Interest: None Declared
According to reported cases of euglycemic diabetic ketacidoses (euDKA) due to use of SGLT-2 receptor antagonists, majority of patients belong to type 1 diabetes (T1DM). This is a good article and should have a good practical implication. Firstly, the use of SGLT-2 receptor antagonists is not cost-effective; secondly, use of this group of drugs is not associated with significant glycemic control in patients with T1DM who are under insulin. Irrespective of type of diabetes; T1DM or T2DM if SGLT-2 receptor antagonists are used, physician should be vigilant about the development of nausea, vomiting or metabolic acidosis even when patient’s glycemic level is <300mg/dl.
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