November 01, 2015
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AACE, ACE: DKA infrequent with SGLT2 therapy

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In a joint meeting of the American Association of Clinical Endocrinologists and the American College of Endocrinology, experts concluded that the risk for diabetic ketoacidosis when using SGLT2 inhibitors is infrequent and the risk-benefit ratio favors continued use.

“With the input of noteworthy expertise assembled during the conference, we achieved our objective of performing a thorough, objective and balanced evaluation of the data in order to issue recommendations for this important issue,” Yehuda Handelsman, MD, FACP, FACE, FNLA, committee program chair and medical director of the Metabolic Institute of American in California, said in a press release.

Yehuda Handelsman

Yehuda Handelsman

Both associations agree that the mechanisms behind the metabolic effect of SGLT2 inhibitors must continue to be investigated by pharmaceutical companies. They also made note that diagnoses of diabetic ketoacidosis (DKA) is often delayed or missed because of atypical presentations that involve lower-than-anticipated glucose levels or other misleading laboratory values.

“The wealth of scientific and clinical data presented at this symposium has been ideal to enhance our understanding of the relationship between SGLT2 inhibitors and DKA,” Robert Henry, MD, FACE, of the Center for Metabolic Research at the San Diego VA Medical Center, said in the release. “I am confident this data will enable AACE to provide recommendations to minimize the occurrence of this complication in patients with diabetes.”

Robert Henry

Robert Henry

The associations recommend that all associated stakeholders provide educational activities to health care professionals who manage diabetes on the appropriate ways to identify and treat DKA.

George Grunberger

George Grunberger

“This successful conference was yet another example of what AACE does best to enhance the ability of its members to deliver optimal care to their patients,” George Grunberger, MD, FACP, FACE, president of AACE, said in the release. “When important clinical issues arise to which we do not have definite answers, we assemble the best minds nationally and globally to examine the available evidence and provide practical guidance to health care professionals and patients as well as to the scientific community to guide future research. We have done this recently for prediabetes, diabetes and cancer, obesity, glucose monitoring and now for the question of the relationship of use of SGLT2 inhibitors and DKA.”