Saturday, May 16, 2015


The US FDA yesterday issued a warning on the use of SGLT2 inhibitors in the management of T2DM. From March 2013 - June 2014, 20 cases of Diabetic ketoacidosis requiring hospital admissions were reported. The SGLT2 inhibitors involved included -Canagliflozin, Dapagliflozin and Empagliflozin. Some were use singularly and others in combination with Metformin and in a few cases with linagliptin. These were patients with T2DM and the average blood sugars were > 200 mMols/L. ( relatively low compared to DKA in T1DM. There also seemed to be a large anion gap in these patients. Half of these patients had triggering factors like sepsis and infections. The other half did not have any obvious triggering factors.
This warning is timely as we see physicians attempts to better control T2DM to target and the use of double or triple therapy with the avoidance of secretogogues. The new kid on the blocks may be effective but we have to keep monitoring them to see what other hidden side effects there maybe even as we embrace their use.

This FDA warning is timely.
We in Malaysia should also monitor our drugs for adverse drug reaction.

1 comment:

Winston Yap said...

Doc, I think that there are many drugs on the market that can cause very serious side effects.
Some time ago, there was even one drug that was so bad that the company making it had to provide an antidote for their medicine!
It is a well known fact that a medicine can used as long as its benefits outweigh its bad side effects.
On the other hand, drugs with plenty of bad side effects should not have been allowed for sale.
Instead, they should be sent back to the drawing board for the serious side effects to be iron out prior to being marketed.
Thank you.