الأربعاء، 20 ديسمبر 2023

Expanding the Use of SGLT2i in Diabetes Beyond Type 2

Diabetes in totally pancreatectomized patients is notoriously difficult to manage. They not only are insulin dependent (like patients with type 1 diabetes [T1D]) but also lack pancreatic glucagon. This is compounded by severe malabsorption (partially controlled with enzyme supplementation), rapid gastric emptying (due to the asportation of the lower part of the stomach and the duodenum) and, usually, a high insulin sensitivity. All these conditions cause rapid fluctuations between hyper- and hypoglycemia (brittle diabetes), with extremely severe hypoglycemic episodes, worsened by the lack of any glucagon response.


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