Ketone production and excretion even during mild hyperglycemia and the impact of sodium-glucose co-transporter inhibition in type 1 diabetes
Authors' conclusion
Even mild hyperglycemia is associated with greater ketone production, compensated by urinary excretion, in T1D. However, SGLTi exaggerates production and partially reduces compensatory excretion, particularly in women.
Study context
- Population
- Adults with T1D (50 % female), aged 24 ± 5 years, HbA1c 8.0 ± 0.9 %, T1D duration 17.5 ± 7 years
- Participants
- 40 adults
- Comparison
- Mild hyperglycemia vs euglycemia, before and after empagliflozin
Methodological details8-week, clamped euglycemia and mild hyperglycemia during extended fasting
- 8-week
- Clamped euglycemia and mild hyperglycemia during extended fasting
Primary result
As reported in the abstract
Urine BHB (production) · prior to treatment
P < 0.001
Further findings
%
| Outcome | Mild hyperglycemia | Euglycemia | P value |
|---|---|---|---|
| BHB fractional excretion | 0.9 (IQR 0.3–1.6) | 0.4 (IQR 0.2–0.9) | P < 0.001 |
Effect of SGLTi during mild hyperglycemia · after 8 weeks of empagliflozin
- Beta-hydroxybutyrate (BHB) fractional excretion decreased to (p < 0.001)
- 0.3 %
- Plasma BHB increased to (p < 0.001)
- 0.21 [0.05-0.40] mmol/L
- SGLTi increased BHB production
- Effect particularly in females (interaction p < 0.001)
Original publication
Ketone production and excretion even during mild hyperglycemia and the impact of sodium-glucose co-transporter inhibition in type 1 diabetes. Diabetes Res Clin Pract. Published 28 November 2023. doi:10.
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