The following is a summary of “Risk of diabetic ketoacidosis caused by sodium glucose cotransporter-2 inhibitors in patients with type 1 diabetes: a systematic review and network meta-analysis of randomized controlled trials,” published in the December 2024 issue of Endocrinology by Liu et al.  

Sodium-glucose cotransporter-2 (SGLT2) inhibitors benefit individuals with type 1 diabetes mellitus (T1DM), but the risk of diabetic ketoacidosis (DKA) limits their widespread use.  

Researchers conducted a retrospective study to evaluate the risk of DKA in people with T1DM treated with different doses of SGLT2 inhibitors.  

They reviewed 19 clinical studies and 1 clinical trial based on RCTs, which were identified from databases of PubMed, Embase, Cochrane Central Register, and ClinicalTrials.gov (December 2023). Data was independently screened, evaluated, and extracted using Stata 15.1 and R 4.1.3 for statistical analysis.  

The results showed that individuals using dapagliflozin 5 mg (OR]: 2.57, 95% CI: 1.04–6.33; P<0.00001), empagliflozin 10 mg (OR: 2.68, 95% CI: 1.11–6.49; P<0.00001), sogliflozin 200 mg (OR: 4.04, 95% CI: 1.15–14.18; P<0.00001), and sogliflozin 400 mg (OR: 5.96, 95% CI: 2.06–17.20; P<0.00001) had a higher likelihood of experiencing DKA compared to placebo. People using canagliflozin 300 mg had the lowest risk of DKA (P=0.8563).  

They concluded that individuals with T1DM treated with dapagliflozin, empagliflozin, and sogliflozin have an increased risk of DKA, while canagliflozin 300 mg demonstrated the lowest DKA risk.  

Source: frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2024.1453067/abstract