People with type 1 diabetes treated with Invokana (canagliflozin) are at an increased risk of developing ketoacidosis, a potentially life threatening acid buildup in the blood. If left untreated, ketoacidosis can lead to diabetic coma and death.
Invokana is in a class of drugs known as SGLT2 inhibitors. The medication was approved by the Food and Drug Administration (FDA) in March 2013 for patients with type 2 diabetes. It is not approved for patients with type 1 diabetes.
A study conducted by researchers with the University of Southern California and published in Diabetes Care tested Invokana on 234 patients with type 1 diabetes over 18 weeks. Another 117 type 1 diabetes patients were treated with a placebo. Researchers found that five out of 117 patients who were given 100 mg/day of Invokana and seven out of 117 treated with 300 mg/day of Invokana developed ketoacidosis. None of the patients treated with the placebo developed ketoacidosis.
“Because of the potentially life-threatening nature of DKA (diabetic ketoacidosis) in patients with type 1 diabetes, further development of SGLT2 inhibitor therapy as a treatment for type 1 diabetes should proceed with caution,” the authors wrote.
In May 2016, the FDA warned that Invokana was linked to cases of ketoacidosis in patients with type 2 diabetes. The concerning thing was that the condition is rarely seen in patients with type 2 diabetes. It is also identified in patients with high levels of ketones in their blood as well as high blood sugar. But the type 2 diabetics on Invokana therapy who were diagnosed with ketoacidosis did not have high blood sugar readings.
Source: Medpage Today