J Korean Diabetes.  2019 Jun;20(2):92-98. 10.4093/jkd.2019.20.2.92.

Sodium-Glucose Cotransporter 2 Inhibitors for People with Type 1 Diabetes

Affiliations
  • 1Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea. mjs7912@yu.ac.kr

Abstract

Althowgh intensive insulin regimen is the main treatment in people with type 1 diabetes, glucose variability and weight gain remain as challenges for this treatment. Sodium-glucose cotransporter (SGLT) inhibitors (including the SGLT1/2 inhibitors) have emerged as an add-on therapy for insulin treatment in peoples with type 1 diabetes due to their insulin-independent mechanism. Recent clinical trials have consistently reported that SGLT inhibition provides additive benefits in glycemic control, including lower insulin dose and weight loss. However, there is concern that an increase in ketone-related adverse events such as diabetic ketoacidosis is higher in SGLT1/2, as well as SGLT2 inhibitors. Despite safety issues that require further evaluation, SGLT2 inhibitors used with caution may provide an adjunctive therapy in people with type 1 diabetes.

Keyword

Diabetes mellitus; type 1; Diabetic ketoacidosis; Insulin; Sodium-glucose cotransporter-2 inhibitor

MeSH Terms

Diabetes Mellitus
Diabetic Ketoacidosis
Glucose
Insulin
Weight Gain
Weight Loss
Glucose
Insulin

Reference

1. Fattah H, Vallon V. The potential role of SGLT2 inhibitors in the treatment of type 1 diabetes mellitus. Drugs. 2018; 78:717–726.
Article
2. Henry RR, Rosenstock J, Edelman S, Mudaliar S, Chalamandaris AG, Kasichayanula S, Bogle A, Iqbal N, List J, Griffen SC. Exploring the potential of the SGLT2 inhibitor dapagliflozin in type 1 diabetes: a randomized, double-blind, placebo-controlled pilot study. Diabetes Care. 2015; 38:412–419.
Article
3. Henry RR, Dandona P, Pettus J, Mudaliar S, Xu J, Hansen L. Dapagliflozin in patients with type 1 diabetes: a post hoc analysis of the effect of insulin dose adjustments on 24-hour continuously monitored mean glucose and fasting β-hydroxybutyrate levels in a phase IIa pilot study. Diabetes Obes Metab. 2017; 19:814–821.
Article
4. Dandona P, Mathieu C, Phillip M, Hansen L, Griffen SC, Tschöpe D, Thorén F, Xu J, Langkilde AM. DEPICT-1 Investigators. Efficacy and safety of dapagliflozin in patients with inadequately controlled type 1 diabetes (DEPICT-1): 24 week results from a multicentre, double-blind, phase 3, randomised controlled trial. Lancet Diabetes Endocrinol. 2017; 5:864–876.
5. Dandona P, Mathieu C, Phillip M, Hansen L, Tschöpe D, Thorén F, Xu J, Langkilde AM. DEPICT-1 Investigators. Efficacy and safety of dapagliflozin in patients with inadequately controlled type 1 diabetes: the DEPICT-1 52-week study. Diabetes Care. 2018; 41:2552–2559.
Article
6. Mathieu C, Dandona P, Gillard P, Senior P, Hasslacher C, Araki E, Lind M, Bain SC, Jabbour S, Arya N, Hansen L, Thorén F, Langkilde AM. DEPICT-2 Investigators. Efficacy and safety of dapagliflozin in patients with inadequately controlled type 1 diabetes (the DEPICT-2 study): 24-week results from a randomized controlled trial. Diabetes Care. 2018; 41:1938–1946.
Article
7. Perkins BA, Cherney DZ, Partridge H, Soleymanlou N, Tschirhart H, Zinman B, Fagan NM, Kaspers S, Woerle HJ, Broedl UC, Johansen OE. Sodium-glucose cotransporter 2 inhibition and glycemic control in type 1 diabetes: results of an 8-week open-label proof-of-concept trial. Diabetes Care. 2014; 37:1480–1483.
Article
8. Pieber TR, Famulla S, Eilbracht J, Cescutti J, Soleymanlou N, Johansen OE, Woerle HJ, Broedl UC, Kaspers S. Empagliflozin as adjunct to insulin in patients with type 1 diabetes: a 4-week, randomized, placebo-controlled trial (EASE-1). Diabetes Obes Metab. 2015; 17:928–935.
Article
9. Famulla S, Pieber TR, Eilbracht J, Neubacher D, Soleymanlou N, Woerle HJ, Broedl UC, Kaspers S. Glucose exposure and variability with empagliflozin as adjunct to insulin in patients with type 1 diabetes: continuous glucose monitoring data from a 4-week, randomized, placebo-controlled trial (EASE-1). Diabetes Technol Ther. 2017; 19:49–60.
Article
10. Rosenstock J, Marquard J, Laffel LM, Neubacher D, Kaspers S, Cherney DZ, Zinman B, Skyler JS, George J, Soleymanlou N, Perkins BA. Empagliflozin as adjunctive to insulin therapy in type 1 diabetes: the EASE trials. Diabetes Care. 2018; 41:2560–2569.
Article
11. Henry RR, Thakkar P, Tong C, Polidori D, Alba M. Efficacy and safety of canagliflozin, a sodium-glucose cotransporter 2 inhibitor, as add-on to insulin in patients with type 1 diabetes. Diabetes Care. 2015; 38:2258–2265.
Article
12. Rodbard HW, Peters AL, Slee A, Cao A, Traina SB, Alba M. The effect of canagliflozin, a sodium glucose cotransporter 2 inhibitor, on glycemic end points assessed by continuous glucose monitoring and patient-reported outcomes among people with type 1 diabetes. Diabetes Care. 2017; 40:171–180.
Article
13. Sims H, Smith KH, Bramlage P, Minguet J. Sotagliflozin: a dual sodium-glucose co-transporter-1 and -2 inhibitor for the management of type 1 and type 2 diabetes mellitus. Diabet Med. 2018; 35:1037–1048.
Article
14. Sands AT, Zambrowicz BP, Rosenstock J, Lapuerta P, Bode BW, Garg SK, Buse JB, Banks P, Heptulla R, Rendell M, Cefalu WT, Strumph P. Sotagliflozin, a dual SGLT1 and SGLT2 inhibitor, as adjunct therapy to insulin in type 1 diabetes. Diabetes Care. 2015; 38:1181–1188.
Article
15. Garg SK, Henry RR, Banks P, Buse JB, Davies MJ, Fulcher GR, Pozzilli P, Gesty-Palmer D, Lapuerta P, Simó R, Danne T, McGuire DK, Kushner JA, Peters A, Strumph P. Effects of sotagliflozin added to insulin in patients with type 1 diabetes. N Engl J Med. 2017; 377:2337–2348.
Article
16. Buse JB, Garg SK, Rosenstock J, Bailey TS, Banks P, Bode BW, Danne T, Kushner JA, Lane WS, Lapuerta P, McGuire DK, Peters AL, Reed J, Sawhney S, Strumph P. Sotagliflozin in combination with optimized insulin therapy in adults with type 1 diabetes: the North American inTandem1 study. Diabetes Care. 2018; 41:1970–1980.
Article
17. Danne T, Cariou B, Banks P, Brandle M, Brath H, Franek E, Kushner JA, Lapuerta P, McGuire DK, Peters AL, Sawhney S, Strumph P. HbA1c and hypoglycemia reductions at 24 and 52 weeks with sotagliflozin in combination with insulin in adults with type 1 diabetes: the European inTandem2 study. Diabetes Care. 2018; 41:1981–1990.
Article
18. Yang Y, Pan H, Wang B, Chen S, Zhu H. Efficacy and safety of SGLT2 inhibitors in patients with type 1 diabetes: a meta-analysis of randomized controlled trials. Chin Med Sci J. 2017; 32:22–27.
Article
19. Chen J, Fan F, Wang JY, Long Y, Gao CL, Stanton RC, Xu Y. The efficacy and safety of SGLT2 inhibitors for adjunctive treatment of type 1 diabetes: a systematic review and meta-analysis. Sci Rep. 2017; 7:44128.
Article
Full Text Links
  • JKD
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr