SGLT-2 Inhibitors in Type 1 Diabetes Mellitus: A Comprehensive Review of the Literature

摘要

Background: Sodium-Glucose Cotransporter 2 (SGTL-2) inhibitors are a new class ofantidiabetics, which have been approved for the treatment of patients with Type 2 Diabetes Mellitus(T2DM). Besides their beneficial metabolic effects, they exert favourable results in cardiovascularevents and risk factors along with renoprotection. However, SGLT-2 inhibitors have not been yetapproved as an adjunct therapy to insulin in patients with Type 1 Diabetes Mellitus (T1DM). Thisreview aims at presenting both clinical and experimental data that reinforce the role of SGLT-2inhibitors as adjunctive treatment in patients with T1DM along with the main restrictions of theiruse, namely Diabetic Ketoacidosis (DKA).Methods: We conducted a comprehensive research of the relevant literature regarding the off-labeluse of SGLT-2 inhibitors in clinical practice, presenting the major benefits and the potential risks.Results: SGLT-2 inhibitors are associated with improved glycemic control, reduction in bodyweight, and decrease in insulin dosage, along with their beneficial cardiovascular and renal effects.However, we cannot overlook the association with increased incidence of DKA events, in the presenceof well known predisposing factors. Further investigation is required, in order to establishthem as adjunctive treatment in those patients.Conclusion: This novel class of antidiabetics seems to be a very attractive treatment option in patientswith T1DM, due to their multiple beneficial effects, but the increased risk of DKA should betaken into account.