Sodium-glucose co-transporter-2 inhibitors in Type 1 Diabetes: A Scoping Review

Hormone Research in Paediatrics

Abstract

Background. With recent developments in diabetes technology, attaining adequate glucose control is more achievable than ever. Despite these improvements a significant proportion of individuals with type 1 diabetes (T1D) do not reach recommended glycaemic goals. Sodium-glucose co-transporter 2 (SGLT2) inhibitors are glucose-lowering agents that inhibit the reabsorption of filtered glucose in the kidneys, thus promoting glucosuria. Because the glucose-lowering effect of SGLT2 inhibitors is achieved independently of insulin secretion, it has been speculated whether they could bridge the gap towards achieving glycaemic targets in individuals with T1D. Objectives. Our main goal was to systematically map the current knowledge on the efficacy and safety of SGLT2 inhibitor use in adults with T1D and present recent studies regarding the use of SGLT2 inhibitors in youth with T1D. Design. Using a scoping review approach, we searched MEDLINE to identify relevant clinical trials of SGLT2 inhibitors as adjunctive therapy to insulin in T1D published from 31-January-2012, to 31-January-2022. We included the most relevant, large-scale (> 300 participants), and long (>18 weeks) placebo controlled clinical trials of SGLT2 inhibitors as an add-on therapy to insulin in adults T1D. Additionally, we included all relevant pilot studies evaluating the use of SGLT2 inhibitors as add-on therapy to insulin in youths with T1D. Finally, we summarized data on glycaemic outcomes and potential safety concerns. Results. We identified eight placebo controlled clinical trials in adults with T1D meeting our inclusion criteria. Additionally, we identified two relevant pilot studies in youth with T1D. The clinical trials in adults with T1D confirmed the efficacy of SGLT2 inhibitors as add-on therapy to insulin. However, this was associated with an increased incidence of DKA versus placebo in all identified clinical trials. The two relevant pilot studies in youths with T1D showed promising results of SGLT2 inhibitor use as an add-on therapy to insulin, especially when combined with a fully closed-loop system. Conclusions. SGLT2 inhibitors, as an add-on therapy to insulin, improve glycaemic outcomes in adults with T1D with a potential cost of increasing the risk of DKA. The use of add-on SGLT2 inhibitors to insulin show promising results in youths with T1D. Moreover, SGLT2 inhibitors as add-on therapy in combination with closed-loop insulin therapy could provide additional benefits in improving glycemic control. The current role of SGLT2 inhibitors as an adjunct therapy to insulin in individuals with type 1 diabetes is yet to be determined.

S. Karger AG, Basel

Article / Publication Details Copyright / Drug Dosage / Disclaimer Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

留言 (0)

沒有登入
gif