Evaluation of the safety of sodium-glucose co-transporter-2 inhibitors for treating patients with type 1 diabetes
- 1 October 2020
- journal article
- research article
- Published by Wiley in Diabetes, Obesity and Metabolism
- Vol. 22 (10), 1767-1776
- https://doi.org/10.1111/dom.14092
Abstract
Aim To conduct an overall safety assessment of sodium-glucose co-transporter-2 (SGLT-2) inhibitors used for the treatment of patients with type 1 diabetes (T1D), including ketoacidosis, genital infection, volume depletion, liver and kidney injury events, cardiovascular events, diarrhea and severe hypoglycaemia. Materials and Methods We searched three databases (Pubmed, Embase and the Cochrane Library) for randomized controlled trials that treated T1D by using SGLT-2 inhibitors from 2000 to 5 March 2020. Results Of the 1653 articles identified that fit our search criteria, 22 studies included qualitative-based results, eight of which were randomized clinical trials that included quantitative-based results. Compared with the control group, the SGLT-2 inhibitors treatment group was found to have had an increased incidence of ketoacidosis (P< .00001, OR 4.34, 95% CI [2.37, 7.96], I-2= 18%), events leading to discontinuation (P< .0001, OR 1.76, 95% CI [1.34, 2.31], I-2= 0%), genital infection (P< .00001, OR 3.64, 95% CI [2.82, 4.70], I-2= 0%), volume depletion (P= .006, OR 2.10, 95% CI [1.23, 3.59], I-2= 4%) and diarrhoea (P= .008, OR 1.64, 95% CI [1.14, 2.36], I-2= 0%). However, according to subgroup analysis, the risk of diarrhoea was dose-related. The incidence of urinary tract infection, cardiovascular events, renal events, liver injury and fracture was not significantly different for the treatment group compared with the control group. Conclusions Despite showing some promise as a treatment approach, the application of SGLT-2 inhibitors for patients with T1D should be considered with caution.Keywords
This publication has 35 references indexed in Scilit:
- Exploring the Potential of the SGLT2 Inhibitor Dapagliflozin in Type 1 Diabetes: A Randomized, Double-Blind, Placebo-Controlled Pilot StudyDiabetes Care, 2014
- Efficacy and safety of empagliflozin for type 2 diabetes: a systematic review and meta‐analysisDiabetes, Obesity and Metabolism, 2014
- Blood pressure effects of sodium–glucose co-transport 2 (SGLT2) inhibitorsJournal of the American Society of Hypertension, 2014
- A Review on the Relationship between SGLT2 Inhibitors and CancerInternational Journal of Endocrinology, 2014
- Efficacy and safety of sodium glucose co‐transport‐2 inhibitors in type 2 diabetes: a meta‐analysis of randomized clinical trialsDiabetes, Obesity and Metabolism, 2013
- Potential role of non‐insulin adjunct therapy in Type 1 diabetesDiabetic Medicine, 2013
- Effect of Sitagliptin on Post-Prandial Glucagon and GLP-1 Levels in Patients With Type 1 Diabetes: Investigator-Initiated, Double-Blind, Randomized, Placebo-Controlled TrialEndocrine Practice, 2013
- Effect of pioglitazone therapy in lean type1 diabetes mellitusDiabetes Research and Clinical Practice, 2007
- Inhibition of DPP-4: a new therapeutic approach for the treatment of type 2 diabetesCurrent Medical Research and Opinion, 2007