Author response for "Evaluation of the safety of SGLT ‐2 inhibitors for treating patients with type 1 diabetes"

INTRODUCTION: Sodium-glucose cotransporter-2 (SGLT-2) inhibitors have been widely used in the treatment of type 2 diabetes mellitus (T2DM) and have been found to achieve good therapeutic results. There is still controversy about SGLT-2 inhibitors and whether or not they can be effectively used for the treatment of patients with type 1 diabetes mellitus (T1DM). MATERIALS AND METHODS: We searched three databases (Pubmed, Embase, and the Cochrane Library) for randomized controlled trials that treated T1DM by using SGLT-2 inhibitors from our study inception through March 5, 2020. RESULTS: Of the 1653 articles we identified that fit our search criteria, 22 studies included in qualitative-based results and 8 randomized clinical trials included quantitative-based results. Compared with the control group, the SGLT-2 inhibitors treatment group was found to have had an increased incidence of: ketoacidosis (P \u003c 0.00001, OR 4.34, 95% CI [2.37, 7.96], I2 =18%), events leading to discontinuation (P \u003c 0.0001, OR 1.76, 95% CI [1.34, 2.31], I2 =0%), genital infection (P \u003c 0.00001, OR 3.64, 95% CI [2.82, 4.70], I2 =0%), volume depletion (P=0.006, OR 2.10, 95% CI [1.23, 3.59], I2 =4%) and diarrhea(P = 0.008, OR 1.64, 95% CI [1.14, 2.36], I2 =0%). However, the risk of diarrhea was dose related according to the subgroup analysis. The incidence of: urinary tract infection (UTI), cardiovascular events, renal events, liver injury, and fracture were not significantly different for experimental groups compared to results for the control groups. CONCLUSIONS: Despite showing some promise as a treatment approach, the application of SGLT-2 inhibitors for patients afflicted with type 1 diabetes mellitus should be carefully considered. This article is protected by copyright. All rights reserved.