Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website http://www.jocmr.org

Letter to the Editor

Volume 11, Number 1, January 2019, pages 76-79

An Effective Insulin Therapy in Combination With Sodium-Glucose Cotransporter 2 Inhibitors

Figures

Figure 1.
Figure 1. Ineffective range of SGLT2 inhibitors. The gray area indicates “ineffective range of SGLT2i” which shows that plasma glucose levels are below the renal threshold for glucose excretion (RTG). Solid and dotted lines indicate plasma glucose levels before and after the addition of SGLT2 inhibitors, respectively.
Figure 2.
Figure 2. A correlation between changes in bolus insulin dose and changes in basal insulin dose by the addition of SGLT2 inhibitors in patients with type 1 diabetes. Correlation was analyzed by Spearman’s correlation.
Figure 3.
Figure 3. The association among bolus and basal insulin dose, plasma glucose and the renal threshold for glucose excretion (RTG) in patients treated with insulin and SGLT2 inhibitors. Solid and dotted lines indicate plasma glucose levels before and after the addition of SGLT2 inhibitors, respectively.

Table

Table 1. Insulin Therapy in Combination With SGLT2 Inhibitors in Type 1 and Type 2 Diabetes
 
AuthorsStudy designSGLT2 inhibitorsChanges in bolus insulin doseChanges in basal insulin dose
RCT, randomized, double-blind, placebo-controlled study; UD, undetermined.
Type 1 diabetic patients
Henry et al [7]RCT (n = 70, 2 weeks)Dapagliflozin 1 mg-19.4%-14.4%
Dapagliflozin 2.5 mg-25.9%-1.1%
Dapagliflozin 5 mg-16.2%-18.0%
Dapagliflozin 10 mg-35.3%-2.5%
Pieber et al. [8]RCT (n = 75, 4 weeks)Empagliflozin 2.5 mg-0.04 U/kg/day (-11.4%)-0.02 U/kg/day (-6.7%)
Empagliflozin 10 mg-0.07 U/kg/day (-20.0%)-0.02 U/kg/day (-5.6%)
Empagliflozin 25 mg-0.03 U/kg/day (-9.1%)-0.03 U/kg/day (-9.4%)
Type 2 diabetic patients receiving insulin therapy
Matsumura et al [9]One-arm (n = 15, 1 week)Canagliflozin 100 mg-112 U/week (-42.1%)-52 U/week (-40.6%)
Hakoshima et al [10]Retrospective observational study (n = 12, 10.2 days)Dapagliflozin 5 mg (n = 6)
Ruseogliflozin 2.5 mg (n = 6)		0-4.6 U/day (-66%)
Rosenstock et al [11]RCT (78 weeks)Empagliflozin 10 mg (n = 169)UD-1.2 U/day
Empagliflozin 25 mg (n = 155)UD-0.5 U/day