PSUN196 Outcomes following SGLT-2 inhibitor use in 99 patients with type 1 diabetes: A single-centre, retrospective, chart-review study

Abstract

Abstract Introduction Despite the numerous benefits seen with the use of SGLT-2 inhibitors in patients with T1DM, the drug class has failed approval for this indication in both the US and Australia, largely due to the increased risk of ketosis and DKA. Resultantly there is limited real-world data for its use in this patient population. Methods We completed a retrospective medical record review of 99 patients with T1DM treated with an SGLT-2 inhibitor within a single outpatient clinic between 2014 to 2021. Our primary objective was to review the change in Hba1c and weight, as well as incidence of DKA, with secondary objectives to review the reduction in insulin dose, and reasons for cessation. Results Baseline characteristics demonstrated a female predominant population (63%) with a median BMI of 30kg/m2. Around half of our patients were on concurrent CSII therapy (53%) We observed an improvement in Hba1c in 72% of our patients, with a median decrease of 0.3% (P=0.001). 80% of patients noted a decrease in weight, with a median reduction of 4.2kg (P=0.10). Five patients developed DKA requiring hospitalisation, and the most common cause for SGLT-2i cessation was genital tract infection. The insulin requirement was noted to decrease by an median of 6.6 units (P=0.04). Conclusion SGLT-2 inhibitor class medications have a valuable role in the treatment of certain patients with T1DM. Our study is one of only a handful of real-life data sets, and unique in the number of patients involved. Future areas for review involve evaluating the effect of risk mitigation measures on the incidence of DKA. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.