This article is more than 5 years old. Information may no longer be current.
DKA incidence low in adults prescribed SGLT2 inhibitors
Adults with type 2 diabetes prescribed SGLT2 monotherapy or an SGLT2 combination treatment have lower incidence rates of diabetic ketoacidosis compared with those prescribed insulin monotherapy, published data show.
Frederik Persson, MD, DMSc, of the Steno Diabetes Center Copenhagen, and colleagues evaluated national registries in Denmark (1995-2014) to estimate incidence rates of diabetic ketoacidosis (DKA) among people with type 2 diabetes who filled prescriptions for antidiabetic medications. Participants were followed until Dec. 31, 2014, death or emigration, whichever occurred first.
Through follow-up, 4,045 first events of DKA occurred in 3 million person-years among 415,670 participants, for a crude incidence rate of 1.34 per 1,000 person-years. The incidence decreased by 5.6% per year.
The HRs for DKA were 1.3 (95% CI, 1.2-1.5) for noninsulin glucose-lowering drugs, 6 (95% CI, 5.3-6.8) for insulin monotherapy and 3 (95% CI, 2.7-3.4) for a combination. Participants who filled prescriptions for SGLT2 inhibitors had no registered DKA events, and six events of DKA occurred in participants prescribed a combination treatment with SGLT2 inhibitors.
“Compared with canagliflozin trials, our DKA incidence rates in the SGLT2 inhibitor-treated groups are higher, but the rates presented here indicate what we are likely to face in clinical practice; out of 1,000 people classified as having type 2 diabetes, one will be hospitalized with DKA each year, a potentially life-threatening acute situation, especially in the older population, demanding hospital admission and intensive treatment,” the researchers wrote. “The excess risk associated with SGLT2 inhibitor treatment was, however, not significant and is hardly clinically relevant.” – by Amber Cox
Disclosure: Persson reports various financial ties with AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Merck Sharp & Dohme, Novartis and Novo Nordisk. Please see the full study for a list of all other authors’ relevant financial disclosures.