Endocrine Abstracts

JOINT3560

Introduction and objectives: Sodium-glucose cotransporter 2 (iSGLT2) inhibitors in type 2 diabetes (DM2) have demonstrated clear metabolic and cardio-renal benefits. Cardio-renal complications are also very common in patients with type 1 diabetes (DM1). However, the risk of developing diabetic ketoacidosis (DKA) has limited the use of these agents in DM1 and especially in certain DM1 subgroups where they would be beneficial. The aim of this study was to evaluate the renal and metabolic evolution of patients with DM1 and high cardiovascular risk at 6 and 12 months after the use of iSGLT2.

Material and methods: Prospective descriptive observational study analysing 22 patients with DM1 who were indicated to start treatment with iSGLT-2 in the Endocrinology outpatient clinic of the San Cecilio Hospital in Granada, Spain. Clinical and analytical variables were measured. The analysis was performed with SPSS 25.0.

Results: Twenty-two patients with DM1 aged between 18 and 65 years old (mean 49.4±11,5 years) were included, half of whom were male. The mean time of evolution of DM1 was 28.9±13.7 years. Thirteen were iSCI users and nine were MDI users. After initiation of iSGLT2 a mean weight loss of 1.8 and 2.8 kg was observed at 6 months and 12 months respectively. HbA1c decreased from a baseline mean of 7.8% to 7.5 and 7.3% at 6 and 12 months respectively. Renal profile: 45.45% of patients had diabetic nephropathy (3 macroalbuminuria and 5 microalbuminuria). From a mean baseline albuminuria of 232.4 mg/g, a decrease of 53 and 87.5mg/g was observed at 6 and 12 months respectively. No episodes of diabetic ketoacidosis (DKA) were observed during follow-up.

Conclusions: The use of iSGLT2 in a DM1 population at high cardiovascular risk resulted in improvement in terms of weight and metabolic control and, above all, a marked decrease in albuminuria without worsening of renal function and without significant DKA or other complications. Therefore, patients with DM1 at high cardiovascular risk and especially with established nephropathy may benefit from the use of iSGLT2.