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Preoperative SGLT-2 inhibitor use and risk of adverse postoperative events: a single-centre retrospective observational study.
Br J Anaesth
January 2025
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Anesthesiology, Medical Faculty and University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Duesseldorf, Germany. Electronic address:
Management of SGLT-2 Inhibitors in the Perioperative Period: Withhold or Continue?
Br J Hosp Med (Lond)
January 2025
Department of Anaesthesia, Northumbria Healthcare NHS Foundation Trust, Newcastle-Upon-Tyne, UK.
Sodium-glucose cotransporter 2 (SGLT-2) inhibitors are commonly prescribed in diabetes mellitus and increasingly for cardiorenal protection. They carry the risk of euglycaemic diabetic ketoacidosis (eDKA). Guidelines around the perioperative handling of these medications are limited and some evidence suggests that withholding them can lead to more surgical complications and poorer glycaemic control.
View Article and Find Full Text PDFGlucose-Lowering Agents Developed in the Last Two Decades and Their Perioperative Implications.
Pharmaceuticals (Basel)
December 2024
Department of Anesthesiology and Perioperative Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA.
The last two decades have provided far more options f both patients and their physicians in the treatment of diabetes mellitus. While dipeptidyl peptidase-4 inhibitors (DPP-4is) and glucagon-like peptide 1 receptor agonists (GLP-1RAs) have been approved for nearly two decades, sodium-glucose cotransporter 2 inhibitors (SGLT-2is) are relatively new. Of interest to perioperative physicians, these drugs present specific perioperative concerns, prompting many societies to issue guidelines.
View Article and Find Full Text PDFUtilization Trends of Glucose-Lowering Medications Among Adult Kidney Transplant Recipients with Type 2 Diabetes in the United States.
J Clin Med
January 2025
Division of Pharmacoepidemiology & Pharmacoeconomics, Brigham and Women's Hospital, Boston, MA 02115, USA.
To date, there are limited studies describing the use of glucose-lowering medications (GLMs) in adult kidney transplant recipients (KTRs), and the uptake of sodium glucose cotransporter-2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP1RAs). Thus, we aimed to evaluate the use of GLMs, including SGLT2i and GLP1RA, among adult KTRs with type 2 diabetes (T2D). This is an ecologic study of adult KTR with T2D.
View Article and Find Full Text PDFA Narrative Review of the Interplay Between Carbohydrate Intake and Diabetes Medications: Unexplored Connections and Clinical Implications.
Int J Mol Sci
January 2025
Department of Pharmacy, University of Limpopo, Mankweng 0727, South Africa.
This narrative review examines the dynamic interplay between carbohydrate intake and diabetes medications, highlighting their combined molecular and clinical effects on glycemic control. Carbohydrates, a primary energy source, significantly influence postprandial glucose regulation and necessitate careful coordination with pharmacological therapies, including insulin, metformin, glucagon-like peptide (GLP-1) receptor agonists, and sodium-glucose cotransporter-2 (SGLT2) inhibitors. Low-glycemic-index (GI) foods enhance insulin sensitivity, stabilize glycemic variability, and optimize medication efficacy, while high-GI foods exacerbate glycemic excursions and insulin resistance.
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