Endocrinology Grand Rounds: Director of GMT DNP Stacey Seggelke presented on euglycemic DKA. How to treat it and how to prevent it. Becoming more common with SGLT2i use.
October 28, 2026 at 11:35 PM
Endocrinology Grand Rounds: Director of GMT DNP Stacey Seggelke presented on euglycemic DKA. How to treat it and how to prevent it. Becoming more common with SGLT2i use.
How has newly diagnosed #Type2Diabetes evolved? A 180k+ cohort over 15 years: older, multimorbid, #MASLD surge, yet better glycaemic management. Uptake of #SGLT2i and #GLP1RA + >5-fold drop in sulfonylureas—a cardiorenal/weight paradigm shift link.springer.com/article/10.1... 🔓
October 27, 2026 at 12:03 PM
How has newly diagnosed #Type2Diabetes evolved? A 180k+ cohort over 15 years: older, multimorbid, #MASLD surge, yet better glycaemic management. Uptake of #SGLT2i and #GLP1RA + >5-fold drop in sulfonylureas—a cardiorenal/weight paradigm shift link.springer.com/article/10.1... 🔓
Acetazolamide effects on natriuresis and diuresis in acute heart failure treated with furosemide and SGLT2i (SANDI) scientiasalut.gencat.cat/handle/11351... #ScientiaVH
Making sure you're not a bot!
scientiasalut.gencat.cat
October 28, 2026 at 7:29 AM
Acetazolamide effects on natriuresis and diuresis in acute heart failure treated with furosemide and SGLT2i (SANDI) scientiasalut.gencat.cat/handle/11351... #ScientiaVH
Systematic review of CV outcomes w/ SGLT2 inhibitors- 5 studies, 11,190 IMID pts (SSc 25%, SLE 71%) SGLT2i use assoc w/ signif lower all-cause mortality and heart failure risk (no clear MI benefit). SGLT2i have establ use in NIDDM, CHF & CKD Pts. buff.ly/uBaeMHA
October 26, 2026 at 7:00 PM
Systematic review of CV outcomes w/ SGLT2 inhibitors- 5 studies, 11,190 IMID pts (SSc 25%, SLE 71%) SGLT2i use assoc w/ signif lower all-cause mortality and heart failure risk (no clear MI benefit). SGLT2i have establ use in NIDDM, CHF & CKD Pts. buff.ly/uBaeMHA
🆕 Safety of Sodium–Glucose Cotransporter 2 Inhibitors in Older Adults With Type 2 #Diabetes: A Cohort Study 🆕
diabetesjournals.org/care/article...
"SGLT2i initiation was not associated with increased risk of harm compared with DPP-4i initiation, although estimates were imprecise for some outcomes"
diabetesjournals.org/care/article...
"SGLT2i initiation was not associated with increased risk of harm compared with DPP-4i initiation, although estimates were imprecise for some outcomes"
Safety of Sodium–Glucose Cotransporter 2 Inhibitors in Older Adults With Type 2 Diabetes: A Cohort Study
OBJECTIVE. Sodium–glucose cotransporter 2 inhibitors (SGLT2is) have demonstrated cardiorenal benefits in individuals with type 2 diabetes, but safety data
diabetesjournals.org
October 30, 2026 at 6:50 PM
🆕 Safety of Sodium–Glucose Cotransporter 2 Inhibitors in Older Adults With Type 2 #Diabetes: A Cohort Study 🆕
diabetesjournals.org/care/article...
"SGLT2i initiation was not associated with increased risk of harm compared with DPP-4i initiation, although estimates were imprecise for some outcomes"
diabetesjournals.org/care/article...
"SGLT2i initiation was not associated with increased risk of harm compared with DPP-4i initiation, although estimates were imprecise for some outcomes"
Here's the patient characteristics, RAAS use was high ~94%, SGLT2i use was low, 21% to avoid confounding. It included diabetics and non-diabetics. They did not split out mGFR difference between diabetic vs not diabetic. I hope we see that at a later date, mostly CKD3a patients
October 24, 2026 at 12:24 PM
Here's the patient characteristics, RAAS use was high ~94%, SGLT2i use was low, 21% to avoid confounding. It included diabetics and non-diabetics. They did not split out mGFR difference between diabetic vs not diabetic. I hope we see that at a later date, mostly CKD3a patients
【CKD入院例へのSGLT2-i開始後eGFR低下で死亡リスク増？/CKJ】Oct.29
中国公的DB、CKD入院後にSGLT2-i開始の1,258例 [平均64歳] 解析——
・23%で20%以上のeGFR「低下」。
・「非低下」例に比べIPTW後比較で45日間「死亡」HRは8.08の有
意高
値。
・一方、「45日後〜1年後」の比較では有意差なし。
抄録🔗 x.gd/UlP3M PDF全文Free
中国公的DB、CKD入院後にSGLT2-i開始の1,258例 [平均64歳] 解析——
・23%で20%以上のeGFR「低下」。
・「非低下」例に比べIPTW後比較で45日間「死亡」HRは8.08の有
意高
値。
・一方、「45日後〜1年後」の比較では有意差なし。
抄録🔗 x.gd/UlP3M PDF全文Free
Substantial Declines in eGFR After Initiation of SGLT2-Inhibitors Associate with Increased Short-term Mortality in Hospitalized Patients With CKD
AbstractBackground. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are recommended as first-line therapy for patients with chronic kidney disease (CKD)
x.gd
October 29, 2026 at 10:56 PM
【CKD入院例へのSGLT2-i開始後eGFR低下で死亡リスク増？/CKJ】Oct.29
中国公的DB、CKD入院後にSGLT2-i開始の1,258例 [平均64歳] 解析——
・23%で20%以上のeGFR「低下」。
・「非低下」例に比べIPTW後比較で45日間「死亡」HRは8.08の有
意高
値。
・一方、「45日後〜1年後」の比較では有意差なし。
抄録🔗 x.gd/UlP3M PDF全文Free
中国公的DB、CKD入院後にSGLT2-i開始の1,258例 [平均64歳] 解析——
・23%で20%以上のeGFR「低下」。
・「非低下」例に比べIPTW後比較で45日間「死亡」HRは8.08の有
意高
値。
・一方、「45日後〜1年後」の比較では有意差なし。
抄録🔗 x.gd/UlP3M PDF全文Free
Novel oral GLP-1 receptor agonist HRS-7535 shows promising efficacy and safety in Chinese individuals with #Type2Diabetes inadequately managed on metformin + SGLT2i in a Phase II trial. #diabetes #T2D #GLP1 #clinicaltrial link.springer.com/article/10.1...
Efficacy and safety of HRS-7535, a novel oral small-molecule glucagon-like peptide-1 receptor agonist, in participants with type 2 diabetes mellitus inadequately controlled by metformin and sodium–glu...
Aims/hypothesis This study aimed to evaluate the efficacy and safety of HRS-7535, an oral small-molecule glucagon-like peptide-1 receptor agonist (GLP-1RA), in Chinese participants with type 2 diabete...
link.springer.com
October 21, 2026 at 4:53 PM
Novel oral GLP-1 receptor agonist HRS-7535 shows promising efficacy and safety in Chinese individuals with #Type2Diabetes inadequately managed on metformin + SGLT2i in a Phase II trial. #diabetes #T2D #GLP1 #clinicaltrial link.springer.com/article/10.1...
【Target Trial Emulationの限界露呈？/Diab Med】Oct.19
台湾公的医療保険DB、2型DMでSGLT2-i開始の224,510例とDPP-4-i開始698,012例をPSオーバーラップ重み付け比較——
・SGLT2-iでDPP-4-iに比べ尿路感染症HRは0.86の有意低値。NNTは「25」[観察期間不明]。
抄録🔗 qr.paps.jp/9DhmF
台湾公的医療保険DB、2型DMでSGLT2-i開始の224,510例とDPP-4-i開始698,012例をPSオーバーラップ重み付け比較——
・SGLT2-iでDPP-4-iに比べ尿路感染症HRは0.86の有意低値。NNTは「25」[観察期間不明]。
抄録🔗 qr.paps.jp/9DhmF
<em>Diabetic Medicine</em> | Diabetes UK Journal | Wiley Online Library
Aims Sodium–glucose cotransporter-2 inhibitors (SGLT2i), a class of oral hypoglycaemic agents (OHAs), have demonstrated cardiovascular and renal benefits. However, safety concerns may hinder their b...
qr.paps.jp
October 20, 2026 at 10:03 PM
【Target Trial Emulationの限界露呈？/Diab Med】Oct.19
台湾公的医療保険DB、2型DMでSGLT2-i開始の224,510例とDPP-4-i開始698,012例をPSオーバーラップ重み付け比較——
・SGLT2-iでDPP-4-iに比べ尿路感染症HRは0.86の有意低値。NNTは「25」[観察期間不明]。
抄録🔗 qr.paps.jp/9DhmF
台湾公的医療保険DB、2型DMでSGLT2-i開始の224,510例とDPP-4-i開始698,012例をPSオーバーラップ重み付け比較——
・SGLT2-iでDPP-4-iに比べ尿路感染症HRは0.86の有意低値。NNTは「25」[観察期間不明]。
抄録🔗 qr.paps.jp/9DhmF
Diabetes drugs and COPD flares.
13 observational studies: vs sulfonylureas, fewer flares with SGLT2i (RR 0.71) and GLP-1 RAs (RR 0.77).
Shabil, Kumar et al. Diabetes Vasc Dis Res 2026
https://pubmed.ncbi.nlm.nih.gov/42821775/
Weekly papers by topic, free: https://papertis.com
#MedSky #PulmSky
13 observational studies: vs sulfonylureas, fewer flares with SGLT2i (RR 0.71) and GLP-1 RAs (RR 0.77).
Shabil, Kumar et al. Diabetes Vasc Dis Res 2026
https://pubmed.ncbi.nlm.nih.gov/42821775/
Weekly papers by topic, free: https://papertis.com
#MedSky #PulmSky
October 16, 2026 at 1:03 PM
Diabetes drugs and COPD flares.
13 observational studies: vs sulfonylureas, fewer flares with SGLT2i (RR 0.71) and GLP-1 RAs (RR 0.77).
Shabil, Kumar et al. Diabetes Vasc Dis Res 2026
https://pubmed.ncbi.nlm.nih.gov/42821775/
Weekly papers by topic, free: https://papertis.com
#MedSky #PulmSky
13 observational studies: vs sulfonylureas, fewer flares with SGLT2i (RR 0.71) and GLP-1 RAs (RR 0.77).
Shabil, Kumar et al. Diabetes Vasc Dis Res 2026
https://pubmed.ncbi.nlm.nih.gov/42821775/
Weekly papers by topic, free: https://papertis.com
#MedSky #PulmSky
There's a local hospital that'll without fail switch my SGLT2i patients over to hydralazine and then send in a 90 day script of it at discharge. Just maddening.
October 14, 2026 at 9:55 AM
There's a local hospital that'll without fail switch my SGLT2i patients over to hydralazine and then send in a 90 day script of it at discharge. Just maddening.
Hospitalization leads to deflozination
dom-pubs.onlinelibrary.wiley.com/doi/10.1111/... h/t @brendonneuen.bsky.social
Often sick day rules cause this. Zero evidence to support sick day rules. Time to stop reflex discontinuation of useful medications
#MedSky
dom-pubs.onlinelibrary.wiley.com/doi/10.1111/... h/t @brendonneuen.bsky.social
Often sick day rules cause this. Zero evidence to support sick day rules. Time to stop reflex discontinuation of useful medications
#MedSky
Hospitalisation Is a Strong Risk Factor for Discontinuation of Sodium‐Glucose Cotransporter 2 Inhibitors for Type 2 Diabetes
Aims Sodium–glucose cotransporter 2 inhibitors (SGLT2i) are commonly withheld during hospitalisation because of concerns about diabetic ketoacidosis. We examined whether hospitalisation was associat...
dom-pubs.onlinelibrary.wiley.com
October 13, 2026 at 10:23 PM
Hospitalization leads to deflozination
dom-pubs.onlinelibrary.wiley.com/doi/10.1111/... h/t @brendonneuen.bsky.social
Often sick day rules cause this. Zero evidence to support sick day rules. Time to stop reflex discontinuation of useful medications
#MedSky
dom-pubs.onlinelibrary.wiley.com/doi/10.1111/... h/t @brendonneuen.bsky.social
Often sick day rules cause this. Zero evidence to support sick day rules. Time to stop reflex discontinuation of useful medications
#MedSky
I stop them consciously to prevent anyone from blaming them for their AKI. If that happens SGLT2i go on the allergy list that travels across EHRs to every system. Good luck ever starting them again. We have found the best approach is stop, schedule 2 week follow-up with nephro note to resume.
October 14, 2026 at 3:19 AM
I stop them consciously to prevent anyone from blaming them for their AKI. If that happens SGLT2i go on the allergy list that travels across EHRs to every system. Good luck ever starting them again. We have found the best approach is stop, schedule 2 week follow-up with nephro note to resume.
Online Now: Unraveling the mechanistic mystery of SGLT2 inhibitors in heart failure #trends #endocrinology #metabolism
Unraveling the mechanistic mystery of SGLT2 inhibitors in heart failure
Heart failure (HF) is a leading cause of hospitalizations and deaths worldwide. Sodium–glucose cotransporter 2 inhibitors (SGLT2i) have been shown to improve HF outcomes despite no evidence of cardiac SGLT2 expression. This forum highlights some proposed mechanisms of SGLT2i efficacy, limitations of these studies, and potential future directions.
dlvr.it
October 12, 2026 at 12:23 PM
Online Now: Unraveling the mechanistic mystery of SGLT2 inhibitors in heart failure #trends #endocrinology #metabolism
Someone needs to whisper to @teorth.bsky.social that we don't even correctly understand how modern cardiovascular drugs work. Doesn't stop them from working.
www.science.org/doi/10.1126/...
www.science.org/doi/10.1126/...
SGLT2 inhibitors activate pantothenate kinase in the human heart
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) reduce mortality in heart failure, but their pharmacological target remains unclear. In this study, we showed that SGLT2i directly activate pantothen...
www.science.org
October 11, 2026 at 3:33 PM
Someone needs to whisper to @teorth.bsky.social that we don't even correctly understand how modern cardiovascular drugs work. Doesn't stop them from working.
www.science.org/doi/10.1126/...
www.science.org/doi/10.1126/...
Actually - a very recent paper seems to have figured this out or has a very clear hypothesis www.science.org/doi/10.1126/...
SGLT2 inhibitors activate pantothenate kinase in the human heart
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) reduce mortality in heart failure, but their pharmacological target remains unclear. In this study, we showed that SGLT2i directly activate pantothen...
www.science.org
October 11, 2026 at 1:57 PM
Actually - a very recent paper seems to have figured this out or has a very clear hypothesis www.science.org/doi/10.1126/...
Which SGLT2i is the best-looking?
Dappergliflozin
Dappergliflozin
October 7, 2026 at 2:46 PM
Which SGLT2i is the best-looking?
Dappergliflozin
Dappergliflozin
New study shows empagliflozin and dapagliflozin have comparable risk of liver-related complications, with only marginally greater improvement in fatty liver with empagliflozin, in adults with type 2 diabetes and MASLD. #MASLD #SGLT2i #T2D #LiverHealth link.springer.com/article/10.1...
Comparative hepatic effectiveness of empagliflozin vs dapagliflozin among individuals with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease - Diabetologia
Aims/hypothesis While both empagliflozin and dapagliflozin are known to improve hepatic steatosis and liver enzyme levels, robust phase 3 trial evidence for improving steatohepatitis and fibrosis is c...
link.springer.com
October 8, 2026 at 4:24 PM
New study shows empagliflozin and dapagliflozin have comparable risk of liver-related complications, with only marginally greater improvement in fatty liver with empagliflozin, in adults with type 2 diabetes and MASLD. #MASLD #SGLT2i #T2D #LiverHealth link.springer.com/article/10.1...
ICYMI - UBC TI #BestEvidence Webinar recording!
"GLP-1 RA and SGLT2i in type 2 diabetes"
Speaker: The TI's @guillaume-grenet.bsky.social
👉 View recording: youtu.be/JUCIfScMqGY
#MedEd #CME #diabetes #CVD
"GLP-1 RA and SGLT2i in type 2 diabetes"
Speaker: The TI's @guillaume-grenet.bsky.social
👉 View recording: youtu.be/JUCIfScMqGY
#MedEd #CME #diabetes #CVD
Dr. Guillaume Grenet: GLP-1 RA and SGLT2i in type 2 diabetes
YouTube video by Therapeutics Initiative
youtu.be
October 6, 2026 at 7:23 PM
ICYMI - UBC TI #BestEvidence Webinar recording!
"GLP-1 RA and SGLT2i in type 2 diabetes"
Speaker: The TI's @guillaume-grenet.bsky.social
👉 View recording: youtu.be/JUCIfScMqGY
#MedEd #CME #diabetes #CVD
"GLP-1 RA and SGLT2i in type 2 diabetes"
Speaker: The TI's @guillaume-grenet.bsky.social
👉 View recording: youtu.be/JUCIfScMqGY
#MedEd #CME #diabetes #CVD
15/ ⚖️Study limitations
⚠️ HF identified from clinical/ICD diagnoses
⚠️ No data on LVEF or natriuretic peptides
⚠️ Study largely predates widespread SGLT2i use in CKD
⚠️ HF identified from clinical/ICD diagnoses
⚠️ No data on LVEF or natriuretic peptides
⚠️ Study largely predates widespread SGLT2i use in CKD
October 5, 2026 at 2:45 PM
15/ ⚖️Study limitations
⚠️ HF identified from clinical/ICD diagnoses
⚠️ No data on LVEF or natriuretic peptides
⚠️ Study largely predates widespread SGLT2i use in CKD
⚠️ HF identified from clinical/ICD diagnoses
⚠️ No data on LVEF or natriuretic peptides
⚠️ Study largely predates widespread SGLT2i use in CKD
Researching and writing about EASD and found these 2015 slides. I'm laughing because outside of glucokinase drugs(approved overseas, not US) none of these drug classes have gone anywhere.
And I'M LAUGHING because now we advise GLP1 and SGLT2i drugs FOR ASCVD risk reduction. How fast things change.
And I'M LAUGHING because now we advise GLP1 and SGLT2i drugs FOR ASCVD risk reduction. How fast things change.
Same. That we've shifted so rapidly in how we treat diabetes is astonishing. Researching my next blog post and stumbled upon these slides from 2015. A year later we got the first CVOT data on semaglutide and EVERYTHING changed.
October 2, 2026 at 1:07 PM
Researching and writing about EASD and found these 2015 slides. I'm laughing because outside of glucokinase drugs(approved overseas, not US) none of these drug classes have gone anywhere.
And I'M LAUGHING because now we advise GLP1 and SGLT2i drugs FOR ASCVD risk reduction. How fast things change.
And I'M LAUGHING because now we advise GLP1 and SGLT2i drugs FOR ASCVD risk reduction. How fast things change.
Yes to the point that I've got into arguments with older providers that I'm being too aggressive with my A1c goals because so many of my patients are 6% or lower.
Nah. Just letting the drugs cook. Tirzepatide + SGLT2i + low dose metformin.
And now this on the horizon.
Nah. Just letting the drugs cook. Tirzepatide + SGLT2i + low dose metformin.
And now this on the horizon.
September 30, 2026 at 10:27 PM
Yes to the point that I've got into arguments with older providers that I'm being too aggressive with my A1c goals because so many of my patients are 6% or lower.
Nah. Just letting the drugs cook. Tirzepatide + SGLT2i + low dose metformin.
And now this on the horizon.
Nah. Just letting the drugs cook. Tirzepatide + SGLT2i + low dose metformin.
And now this on the horizon.
＜（ドクター用）CKDと心不全とSGLT2i（ジャディアンス） ❷＞ ASIAN-HF Registryに参加した心不全患者を対象とした調査では、CKDを合併すると、HFrEFおよびHFpEFのどちらにおいても全死亡または心不全による入院のハザード比が1.00を超えることが報告されている。
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医師のための総合医療情報ならm3.com。日々の診療や臨床・医学研究に役立つ医薬品情報、医療ニュース、学会情報、医学文献検索、医師掲示板、求人募集・転職情報、薬剤検索、医院開業・経営・集患ノウハウなど医師専用コンテンツが充実
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October 1, 2026 at 2:57 PM
＜（ドクター用）CKDと心不全とSGLT2i（ジャディアンス） ❷＞ ASIAN-HF Registryに参加した心不全患者を対象とした調査では、CKDを合併すると、HFrEFおよびHFpEFのどちらにおいても全死亡または心不全による入院のハザード比が1.00を超えることが報告されている。
nbi6.m3.com/contents/jar...
（要ログイン）
nbi6.m3.com/contents/jar...
（要ログイン）
＜（ドクター用）CKDと心不全とSGLT2i（ジャディアンス） ❸＞
心不全では、腎血流量の減少や腎血流障害およびその結果として生じる虚血性腎障害によって、腎機能低下が促進される。一方、慢性腎臓病（CKD）では、体液過剰（fluid overload）、貧血、尿毒症、レニン-アンジオテンシン-アルドステロン系（RAAS）および交感神経の活性化の結果として、左室リモデリング / 線維化、心機能不全が促進される。
心不全では、腎血流量の減少や腎血流障害およびその結果として生じる虚血性腎障害によって、腎機能低下が促進される。一方、慢性腎臓病（CKD）では、体液過剰（fluid overload）、貧血、尿毒症、レニン-アンジオテンシン-アルドステロン系（RAAS）および交感神経の活性化の結果として、左室リモデリング / 線維化、心機能不全が促進される。
October 1, 2026 at 2:59 PM
＜（ドクター用）CKDと心不全とSGLT2i（ジャディアンス） ❸＞
心不全では、腎血流量の減少や腎血流障害およびその結果として生じる虚血性腎障害によって、腎機能低下が促進される。一方、慢性腎臓病（CKD）では、体液過剰（fluid overload）、貧血、尿毒症、レニン-アンジオテンシン-アルドステロン系（RAAS）および交感神経の活性化の結果として、左室リモデリング / 線維化、心機能不全が促進される。
心不全では、腎血流量の減少や腎血流障害およびその結果として生じる虚血性腎障害によって、腎機能低下が促進される。一方、慢性腎臓病（CKD）では、体液過剰（fluid overload）、貧血、尿毒症、レニン-アンジオテンシン-アルドステロン系（RAAS）および交感神経の活性化の結果として、左室リモデリング / 線維化、心機能不全が促進される。
＜（ドクター用）CKDと心不全とSGLT2i（ジャディアンス） ❶＞ 本邦の前向き観察研究 「JCARE-CARD研究 」では、心不全の悪化により入院した患者の71.2%が退院時にeGFR＜60mL/min/1.73m2であった。
また、eGFRが低いほど全死亡および心不全による再入院のリスクが高かったことが報告されている。こうした腎機能低下によるリスクは、左室駆出率の低下の有無にかかわらずみられる可能性が示唆されている。
また、eGFRが低いほど全死亡および心不全による再入院のリスクが高かったことが報告されている。こうした腎機能低下によるリスクは、左室駆出率の低下の有無にかかわらずみられる可能性が示唆されている。
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医師のための総合医療情報ならm3.com。日々の診療や臨床・医学研究に役立つ医薬品情報、医療ニュース、学会情報、医学文献検索、医師掲示板、求人募集・転職情報、薬剤検索、医院開業・経営・集患ノウハウなど医師専用コンテンツが充実
nbi6.m3.com
October 1, 2026 at 2:46 PM
＜（ドクター用）CKDと心不全とSGLT2i（ジャディアンス） ❶＞ 本邦の前向き観察研究 「JCARE-CARD研究 」では、心不全の悪化により入院した患者の71.2%が退院時にeGFR＜60mL/min/1.73m2であった。
また、eGFRが低いほど全死亡および心不全による再入院のリスクが高かったことが報告されている。こうした腎機能低下によるリスクは、左室駆出率の低下の有無にかかわらずみられる可能性が示唆されている。
また、eGFRが低いほど全死亡および心不全による再入院のリスクが高かったことが報告されている。こうした腎機能低下によるリスクは、左室駆出率の低下の有無にかかわらずみられる可能性が示唆されている。