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Potential Safety Issues with Use of Sodium-Glucose Cotransporter 2 Inhibitors, Particularly in People with Type 2 Diabetes and Chronic Kidney Disease.
Milder, Tamara Y; Stocker, Sophie L; Day, Richard O; Greenfield, Jerry R.
  • Milder TY; Department of Diabetes and Endocrinology, St. Vincent's Hospital, Sydney, Australia.
  • Stocker SL; Department of Clinical Pharmacology and Toxicology, St. Vincent's Hospital, Sydney, Australia.
  • Day RO; Diabetes and Metabolism, Garvan Institute of Medical Research, Sydney, Australia.
  • Greenfield JR; St. Vincent's Clinical School, University of NSW, Sydney, Australia.
Drug Saf ; 43(12): 1211-1221, 2020 12.
Article in English | MEDLINE | ID: covidwho-1092871
ABSTRACT
Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a major advance in the fields of diabetology, nephrology, and cardiology. The cardiovascular and renal benefits of SGLT2 inhibitors are likely largely independent of their glycaemic effects, and this understanding is central to the use of these agents in the high-risk population of people with type 2 diabetes and chronic kidney disease. There are a number of potential safety issues associated with the use of SGLT2 inhibitors. These include the rare but serious risks of diabetic ketoacidosis and necrotising fasciitis of the perineum. The data regarding a possibly increased risk of lower limb amputation and fracture with SGLT2 inhibitor therapy are conflicting. This article aims to explore the potential safety issues associated with the use of SGLT2 inhibitors, with a particular focus on the safety of these drugs in people with type 2 diabetes and chronic kidney disease. We discuss strategies that clinicians can implement to minimise the risk of adverse effects including diabetic ketoacidosis and volume depletion. Risk mitigation strategies with respect to SGLT2 inhibitor-associated diabetic ketoacidosis are of particular importance during the current coronavirus disease 2019 (COVID-19) pandemic.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetic Ketoacidosis / Fasciitis, Necrotizing / Hypovolemia / Diabetes Mellitus, Type 2 / Renal Insufficiency, Chronic / Sodium-Glucose Transporter 2 Inhibitors Type of study: Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Drug Saf Journal subject: Drug Therapy / Toxicology Year: 2020 Document Type: Article Affiliation country: S40264-020-01010-6

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetic Ketoacidosis / Fasciitis, Necrotizing / Hypovolemia / Diabetes Mellitus, Type 2 / Renal Insufficiency, Chronic / Sodium-Glucose Transporter 2 Inhibitors Type of study: Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Drug Saf Journal subject: Drug Therapy / Toxicology Year: 2020 Document Type: Article Affiliation country: S40264-020-01010-6