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A recent study from Emory University’s Rollins School of Public Health has raised concerns about the off-label prescription of glucose-lowering medications, specifically GLP-1 receptor agonists (GLP-1RAs) and SGLT2 inhibitors, for individuals with type 1 diabetes. Published in JAMA, the study highlights potential risks associated with the use of these drugs, which are primarily used to treat type 2 diabetes, in patients with type 1 diabetes.
While GLP-1RAs and SGLT2 inhibitors have gained popularity due to their cardiovascular and renal benefits, as well as their ability to aid in weight loss, their safety for type 1 diabetes patients remains in question. The study revealed that SGLT2 inhibitors, which are not FDA-approved for use in type 1 diabetes, have been linked to euglycemic diabetic ketoacidosis (EDKA), a potentially fatal condition characterized by dangerously high blood acidity despite normal glucose levels.
Data from the Epic Cosmos database, analyzing 943,456 individuals with type 1 diabetes from 2010 to 2023, showed troubling outcomes for patients using these drugs. Those prescribed SGLT2 inhibitors exhibited higher incidences of heart failure and kidney disease. Additionally, patients using GLP-1RAs showed a rise in obesity rates, raising further concerns about the long-term impact of these medications on this vulnerable population.
The researchers concluded that extreme caution should be exercised when considering these treatments for type 1 diabetes. They urged for more comprehensive safety and efficacy studies to better understand the potential benefits and risks involved. Until then, healthcare professionals are advised to weigh the possible adverse effects before prescribing these drugs off-label.
Disclaimer: This article is based on a study conducted by Emory University’s Rollins School of Public Health and published in JAMA. The information provided is for general knowledge and should not be considered medical advice. Individuals with type 1 diabetes should consult with a healthcare provider before making any changes to their treatment regimen.
