Younger patients and low c‐peptide immunoreactivity index but not nutritional states affect fasting blood ketone levels in Japanese with type 1 diabetes after sodium‐glucose cotransporter 2 inhibitor administration
Authors' conclusion
When administering SGLT2is to patients with a low CPR index or younger patients with type 1 diabetes, adequate instructions to prevent ketosis should be given.
Study context
- Population
- Japanese patients with T1D taking SGLT2is
- Participants
- 46 patients
- Exposure
- Ketone levels before vs after SGLT2i administration
- Outcome
- Mean ketone concentrations
Methodological detailsbefore-after comparison
- Before-after comparison
Main finding
As reported in the abstract
- Correlation of average morning ketone levels with age after SGLT2is
- r = −0.514, p < .001
- Correlation of average morning ketone levels with CPR index after SGLT2is
- r = −0.523, p = .038
- Multiple regression: younger age associated with increasing ketone levels after SGLT2is
- β = −0.504, p = .003
- Multiple regression: low ratio of basal to bolus insulin associated with increasing ketone levels after SGLT2is
- β = −0.420, p = .005
Observational data: associations, not effects.
Further findings
Mixed-effects model (before SGLT2is)
- Patient-to-patient and age, or patient-to-patient and insulin secretion capacity, influenced ketone levels
Original publication
Younger patients and low c‐peptide immunoreactivity index but not nutritional states affect fasting blood ketone levels in Japanese with type 1 diabetes after sodium‐glucose cotransporter 2 inhibitor administration. Diabetes Obes Metab. Published 5 September 2023. doi:10.
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