Clinical Guidance on the Safe Use of Sodium-Glucose Cotransporter Inhibitors in Adults with Type 1 Diabetes

Authors

• Jayachidambaram Ambalavanan, MaineHealth
• Kanchan Bhasin, Division of Endocrinology and Metabolism, Indiana University School of Medicine, Indianapolis, IN, USA.
• Viral N. Shah, Division of Endocrinology and Metabolism, Indiana University School of Medicine, Indianapolis, IN, USA.

Document Type

Article

Publication Date

9-2026

Institution/Department

Endocrinology & Diabetes

Journal Title

Endocrinology and metabolism clinics of North America

MeSH Headings

Humans; Diabetes Mellitus, Type 1 (drug therapy); Diabetic Ketoacidosis (prevention & control, chemically induced); Hypoglycemic Agents (therapeutic use, adverse effects); Practice Guidelines as Topic (standards); Adult; Sodium-Glucose Transporter 2 Inhibitors; Sodium-Glucose Transport Proteins (antagonists & inhibitors)

Abstract

Sodium-glucose cotransporter inhibitors (SGLTi) as an adjunctive to insulin therapy may offer cardiometabolic and renal benefits in adults with type 1 diabetes (T1D). Their effective use depends on patient selection, education, and ketone monitoring to prevent diabetic ketoacidosis (DKA). Starting with the lowest effective dose, making appropriate insulin adjustments, and following structured protocols for ketone monitoring and DKA risk mitigation are essential for safe use of SGLTi in adults with T1D.

First Page

537

Last Page

546

Recommended Citation

Ambalavanan, Jayachidambaram; Bhasin, Kanchan; and Shah, Viral N., "Clinical Guidance on the Safe Use of Sodium-Glucose Cotransporter Inhibitors in Adults with Type 1 Diabetes" (2026). MaineHealth Maine Medical Center. 4613.
https://knowledgeconnection.mainehealth.org/mmc/4613