Canagliflozin use in Type I diabetes mellitus

ABSTRACT

Peters et al documented the appearance of diabetic ketoacidosis without significant elevation of serum glucose in patients treated with Canagliflozin. They solicited patient reports from their practice and from other colleagues’ practices and identified nine patients, mainly with Type I Diabetes. Erondu et al evaluated the Canagliflozin development data base to describe the rate and appearance of ketoacidosis in the study patients. They found that in the research patients with Type 2 Diabetes, the rate of ketoacidosis in Canagliflozin patients was uncommon and similar to the reported rate in Type 2 patients not receiving Canagliflozin. Finally, Henry et al reported on a research program that added Canagliflozin onto insulin therapy in Type I patients, finding that there were only modest improvements in HgBA1 C levels and weight, while this therapy produced increased levels of ketosis and 6% rate of ketoacidosis in Canagliflozin patients. This information strongly suggests that Canagliflozin, and possibly the other SGLT-2 inhibitors, are not proper therapy for patients with Type I Diabetes.

KEYWORDS:

• Type 1 diabetes
• canagliflozin
• SGLT-2 inhibitors
• diabetic ketoacidosis
• ketosis

Declaration of interest

R Guthrie has been a consultant and speaker for Janssen, Boehringer Ingelheim, and AstraZeneca. He is also the Editor-in-Chief of The Physician and Sportsmedicine, another Taylor & Francis journal. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded