Cases of ketoacidosis were reported in type 1 diabetic patients taking insulin in combination with the diabetes medication Invokana as early as 18 weeks after starting the drug, according to researchers with the American Diabetes Association.
Invokana is approved to treat patients with type 2 diabetes, but the drug has been tested in patients with type 1 diabetes. Studies have already linked Invokana (known chemically as canagliflozin) and other type 2 diabetes drugs in the same class known as sodium glucose cotransporter 2 (SGLT2) inhibitors, with an increased risk of ketoacidosis. The new study aimed to evaluate whether the incidence of serious adverse events of diabetic ketoacidosis was just as prevalent in type 1 diabetics.
Ketoacidosis is a serious condition in which too much acid builds up in the blood. If left untreated, it can lead to diabetic coma and death. It is most commonly seen in type 1 diabetics and it generally is accompanied by high blood sugar readings. But patients with type 2 diabetes taking Invokana have been diagnosed with ketoacidosis. In these patients, blood sugar readings were not high.
The randomized, double-blind, dose-dependent study, which was published in the Diabetes Care Journals, involved 351 type 1 diabetics who were already on multiple daily injections of insulin delivered by an insulin pump. The participants were randomly assigned to two groups – one receiving either 100 or 300 mg of Invokana per day while the other was given a placebo. Researchers found that cases of ketoacidosis were reported as early as 18 weeks after starting the drug. They also found that the rate of ketoacidosis was 5.1 percent for patients treated with 100 mg of Invokana and 9.4 percent for patients taking 300 mg of Invokana.
More studies on Invokana in patients with type 1 diabetes to better evaluate the ketoacidosis risk are currently underway.
Source: Diabetes in Control