News in brief: Don’t use SGLT2 inhibitors in T1D; Diabetes researcher given gender equity role; DOACs less risky than warfarin in people with diabetes and AF

Tuesday, 15 Feb 2022

Don’t use SGLT2 inhibitors in T1D

The TGA has reminded prescribers that sodium glucose co-transporter 2 (SGLT2) inhibitors are only approved for treatment of patients with type 2 diabetes  (T2D) and must not be used for patients with type 1 diabetes.

In a Safety Advisory statement the TGA said it continued to receive reports of off-label use of SGLT2 inhibitors in T1D, which was a concern given the reported eight-fold increase in risk of ketoacidosis with the drugs in this patient population.

“The TGA considers that the seriousness of the risk of DKA requires an updated reminder for prescribers about the risks of off-label use of SGLT2 inhibitors in T1DM patients,” it said

The reminder applied to the SGLT2 inhibitors empagliflozin, dapagliflozin, ertugliflozin and canagliflozin, marketed in Australia as Jardiance, Forxiga, Steglatro and Invokana, respectively.

Diabetes researcher given gender equity role

Diabetes researcher Professor Dianna Magliano of the Baker Institute, Melbourne, has been appointed a five-year Alice Baker and Eleanor Shaw Gender Equity Fellow.

The Fellowships support early career scientists and their focus has recently turned to senior five-year appointments recognising the widespread difficulty of recruiting and retaining talented senior female researchers.

Professor Magliano heads the institute’s Diabetes and Population Health Unit, and has played a pivotal role in recognising and predicting the current global pandemic of diabetes.

Baker Institute Director, Professor Tom Marwick said the Fellowships were part of the Institute’s Gender Equity and Diversity program to support more senior women in Australian science.

“Not only is Professor Magliano an outstanding diabetes epidemiologist who is recognised globally for her research, but she is a well-known advocate in the gender equity arena, providing a strong role model both at the Institute and in the sector more widely,” he said.

DOACs less risky than warfarin in people with diabetes and AF

DOACs appear safer than warfarin for patients who have diabetes and atrial fibrillation according to a study published in the Annals of Internal Medicine.

A retrospective review of data from 19,909 DOAC users and 10 300 warfarin users with diabetes found that non–vitamin K antagonist oral anticoagulants were associated with lower risk of developing macrovascular complications (Hazard Ratio, 0.84 [95% CI, 0.78 to 0.91]; P < 0.001) compared to warfarin users.

DOAC use was also associated with a lower risk of microvascular complications (HR, 0.79 [CI, 0.73 to 0.85]; P < 0.001), glycaemic emergency (HR, 0.91 [CI, 0.83 to 0.99]; P = 0.043), and mortality (HR, 0.78 [CI, 0.75 to 0.82]; P < 0.001) than use of warfarin.

Analyses with propensity score matching showed similar results, according to researchers from Taiwan.

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