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Posted by on Aug 8, 2017 in Diabetes mellitus | 0 comments

In a nutshell

This study examined the safety and effectiveness of SGLT2 inhibitors in addition to insulin in patients with type 2 diabetes (T2D). It determined that these drugs improve glycemic control (control of blood glucose levels), but increase the risk of some side effects.

Some background

SGLT2 is a protein in the kidneys that is important in controlling blood glucose levels. It allows glucose to re-enter blood from the kidneys. SGLT2 inhibitors are a type of treatment that prevents this. Some evidence suggests that SGLT2 inhibitors improve insulin sensitivity and thus may be useful in addition to insulin. However, results from some studies are variable.

Methods & findings

This study examined data from 7 different studies. These studies compared SGLT2 inhibitors, in addition to insulin, with placebo (drug with no active effect). Some patients were also taking other anti-diabetic drugs. 4235 patients with T2D were examined.

HbA1c (measures average blood glucose over the last 3 months) was reduced by 0.56% in patients taking SGLT2 inhibitors. Fasting blood glucose (glucose levels after a period without food or drink) also fell by 0.95 mmol/L. Patients taking SGLT2 inhibitors also lost weight and reduced their insulin dose.

Patients taking SGLT2 inhibitors had a 357% increased risk of genital infections and a 29% higher risk of urinary tract infections. Drug-related side effects were 36% higher in those taking SGLT2 inhibitors. However, overall side effects and serious side effects were similar in patients treated with SGLT2 inhibitors and patients taking the placebo. The risk of hypoglycemia (dangerously low blood glucose) was similar for both groups. 

The bottom line

The study concluded that SGLT2 inhibitors, in addition to insulin, improve glycemic control, but increase the risk of certain side effects.

The fine print

The majority of patients in these studies were obese and were 50 years or older. Thus the results may not apply equally to all patients with T2D. Furthermore, differences between the 7 studies (such as type of SGLT2 inhibitor examined, length of treatment) may have affected the results.

What’s next?

Discuss the use of SGLT2 inhibitors with your physician. 

Published By :

Diabetes, Obesity and Metabolism

Date :

Sep 06, 2016

Original Title :

Sodium-glucose cotransporter 2 inhibitors in addition to insulin therapy for management of type 2 diabetes mellitus: a meta-analysis of randomized controlled trials.

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