![\"News](\"https:\/\/media.healthday.com\/Images\/icimages\/WHI092MH.jpg\"\/)
By Serena Gordon<\/b>
HealthDay Reporter<\/i><\/p>\n
WEDNESDAY, July 29, 2020<\/p>\n
People taking a class of diabetes medications<\/a> called SGLT2s have up to three times the risk for a serious complication called diabetic ketoacidosis<\/a> (DKA) compared to people taking another drug, new research reveals.<\/p>\n SGLT2 (sodium-glucose cotransporter-2) inhibitors — such as Farxiga<\/a>, Jardiance <\/a>and Invokana<\/a> — are a newer type of oral diabetes<\/a> medicine. This class of medications is known to have many positive effects, including lowering a patient’s risk of heart attack<\/a>, heart failure<\/a>, kidney disease<\/a> and death from heart disease<\/a>.<\/p>\n But several troubling side effects, including infections and a possible increased risk of DKA, have emerged.<\/p>\n “There was some uncertainty about how much the risk of DKA was, so we wanted to get a more precise estimate of the risk. We found a threefold increased risk,” said senior author Kristian Filion. He’s an investigator in clinical epidemiology at the Lady Davis Institute at Jewish General Hospital in Montreal, Canada.<\/p>\n “DKA appears to be a side effect of SGLT2s,” he said. “It’s an adverse effect that physicians need to be aware of, and alert their patients to.”<\/p>\n SGLT2 inhibitors<\/a> cause the kidneys to remove blood sugar<\/a> through urination, which lowers overall blood sugar<\/a> levels, according to the U.S. Food and Drug Administration.<\/p>\n Dr. Akankasha Goyal, an endocrinologist at NYU Langone Health in New York City, explained that when SGLT2s lower blood sugar<\/a> levels, insulin<\/a> production slows. Insulin<\/a> is a hormone that is necessary for moving sugar<\/a> from the blood into the body’s cells.<\/p>\n If you don’t have enough insulin to let your blood sugar fuel your cells, the body turns to stored fat for energy. A by-product of this process is ketones, according to the American Diabetes<\/a> Association (ADA).<\/p>\n If ketones build up in the blood, it becomes more acidic and causes diabetic ketoacidosis<\/a>, Goyal explained.<\/p>\n “DKA is a diabetic emergency. Someone in DKA needs to be hospitalized,” she said. The condition is usually rare in people with type 2 diabetes<\/a> because they usually make enough insulin to prevent it, she added.<\/p>\n Untreated, DKA can lead to death, the ADA said.<\/p>\n The new study included more than 200,000 people with type 2 diabetes<\/a> who started using SGLT2 inhibitors<\/a> between 2013 and 2018. They were compared to a matched group of people who took a different class of diabetes<\/a> medications called DPP-4 inhibitors.<\/p>\n During the study, 521 people were diagnosed with DKA.<\/p>\n For people taking SGLT2 inhibitors, the risk of DKA was nearly three times higher, the study found. And, risk varied with the type of SGLT2 inhibitor used.<\/p>\n Dapagliflozin<\/a> (Farxiga<\/a>) was linked to an 86% increase in DKA risk, while patients using empagliflozin<\/a> (Jardiance) had 2.5 times the risk of DKA compared to those on DPP-4s, the study found. Canagliflozin<\/a> (Invokana<\/a>) was associated with 3.6 times higher odds of DKA.<\/p>\n The good news, however, is that you can take steps to prevent DKA and get the benefits of SGLT2 inhibitors.<\/p>\n Goyal said the risk of DKA is highest when someone begins taking an SGLT2 inhibitor. Staying hydrated is a good way to help prevent it. It’s also important to check with your diabetes<\/a> doctor before taking any new medications. And, find out how often you should check your blood sugar levels.<\/p>\n She said it’s also important to be aware of the DKA symptoms so you can seek treatment without delay if needed.<\/p>\n Symptoms include dry mouth<\/a>, frequent thirst<\/a> and urination, fatigue<\/a>, nausea<\/a> and vomiting<\/a>, trouble concentrating and fruity-smelling breath, according to the ADA.<\/p>\n
Goyal said SGLT2 inhibitors are a potent and effective class of medications.<\/p>\n “They really help with diabetes<\/a> and heart<\/a> failure, and can even help with cardiovascular risk in people who don’t yet have heart disease<\/a>,” she said. “These medications are really good for people with kidney disease<\/a>, too. And they’re easy. One pill, once a day.”<\/p>\n Filion said all drugs<\/a> have benefits and risks that should be brought to patients’ attention.<\/p>\n “These drugs<\/a> have been shown to lower blood glucose levels and have benefits for the heart<\/a> and kidneys. They also have some risks,” he said. “Patients and physicians need to discuss the benefits and risks, particularly the risk factors for DKA.”<\/p>\n The report was published online July 28 in the Annals of Internal Medicine<\/i>.<\/p>\n <\/p><\/div>\n References<\/p>\n
\n ![](\"https:\/\/images.medicinenet.com\/images\/quiz\/type-2-diabetes\/type-2-diabetes-s1.jpg\"\/)
\n
<\/p>\nQUESTION<\/h4>\n
\n ______________ is another term for type 2 diabetes.<\/span>
\n See Answer<\/span>
\n<\/a><\/p><\/div>\n![\"MedicalNews\"](\"https:\/\/images.medicinenet.com\/images\/HealthDay\/healthday.png\")
Copyright \u00a9 2020 HealthDay. All rights reserved.<\/p>\n
\n SOURCES: Kristian Filion, PhD, investigator, clinical epidemiology, Lady Davis Institute at Jewish General Hospital, and associate professor, medicine and epidemiology, McGill University, Montreal, Canada; Akankasha Goyal, MD, endocrinologist, NYU Langone Health, New York City; Annals of Internal Medicine<\/i>.
\n <\/p>\n<\/p><\/div>\n