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Diabetes Med Linked to Dangerous Complication

By Robert Preidt

HealthDay Reporter

WEDNESDAY, June 7, 2017 (HealthDay News) — A brand new class of type 2 diabetes medicine referred to as SGLT2 inhibitors might improve the danger of a uncommon, life-threatening complication of the illness referred to as ketoacidosis, a brand new research warns.

SGLT2 inhibitors embrace prescription drugs akin to canagliflozin, dapagliflozin and empagliflozin. Brand names are Invokana, Invokamet, Farxiga, Xigduo XR, Jardiance and Glyxambi.

These medicine first turned obtainable in 2013, however in 2015 the U.S. Food and Drug Administration issued a warning about an elevated danger for diabetic ketoacidosis when SGLT2 inhibitors are used.

The situation sometimes happens in individuals with type 1 diabetes. And whereas it’s unusual in individuals with type 2 diabetes, case reviews have proven it might happen with sort 2 illness, in accordance to the research authors.

Ketoacidosis may cause vomiting, abdominal pain, shortness of breath and swelling within the mind. Left untreated, the situation might be deadly, the researchers stated.

The new research “essentially confirms what doctors had already suspected,” stated diabetes skilled Dr. Stanislaw Klek, an endocrinologist at NYU Winthrop Hospital in Mineola, N.Y.

“Fortunately, the rate of diabetic ketoacidosis is still very low and should not prevent the usage of this medication class,” he added. “It is important to be aware of this potential complication and monitor for symptoms of diabetic ketoacidosis, particularly during periods of illness.”

In the brand new research, researchers at Brigham and Women’s Hospital in Boston analyzed knowledge from 40,000 individuals with type 2 diabetes. They discovered that these taking SGLT2 inhibitors have been twice as doubtless to develop diabetic ketoacidosis than these taking one other class of diabetes medicine referred to as DPP4 inhibitors (medicine akin to Januvia and Onglyza).

Still, the danger to anybody affected person stays very slim, the researchers harassed. They estimated that amongst sufferers taking an SGLT2 inhibitor, solely about 1 in each 1,000 sufferers would develop this ketoacidosis.

The findings have been revealed June eight within the New England Journal of Medicine.

Even although diabetic ketoacidosis is rare, docs want to intently monitor type 2 diabetes sufferers for indicators and signs of the complication, stated research writer Dr. Michael Fralick. He’s from Brigham and Women’s division of pharmacoepidemiology and pharmacoeconomics.


“This is a aspect impact that is often seen in sufferers with type 1 diabetes mellitus — not sort 2 — so docs will not be ‘looking out’ for it,” Fralick stated in a hospital information launch. “That means that the risk of this side effect might actually be even higher than what we found due to misdiagnosis/under-recording.”

Dr. Minisha Sood is an endocrinologist at Lenox Hill Hospital in New York City. Reviewing the findings, she defined that SGLT2 inhibitors “have been a welcome addition to the arsenal of glucose [blood sugar]-lowering drugs. They decrease blood glucose by growing the quantity of glucose eradicated by means of the urine.”

But the medicine might intrude with ranges of a specific hormone, glucagon, which in flip leads to an unhealthy rise in acids referred to as ketones. “When ketone acids build up in the system, this can lead to diabetic ketoacidosis,” Sood defined.

She agreed that sufferers and docs must be alert to the uncommon however potential danger for diabetic ketoacidosis, particularly within the early weeks after an individual begins taking an SLGT2 inhibitor.

But Sood believes the research findings aren’t purpose for sufferers to instantly change to one other type of diabetes treatment.

“SLGT2 inhibitors work extraordinarily nicely to management diabetes [they usually have the additional advantage of decreasing blood pressure and weight as nicely] so the advantages undoubtedly outweigh the dangers of remedy,” she stated.

WebMD News from HealthDay


SOURCES: Stanislaw Klek, M.D., endocrinologist, NYU Winthrop Hospital, Mineola, N.Y.; Minisha Sood, M.D., endocrinologist, Lenox Hill Hospital, New York City; Brigham and Women’s Hospital, information launch, June 7, 2017

Copyright © 2013-2017 HealthDay. All rights reserved.

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