Adverse reactions to canagliflozin could not be reliably verified without access to medical claims data and thus were not reported. type 1 diabetes, providers have prescribed these agents for off-label use in this patient population. Glycemic variability may be problematic in patients with type 1 diabetes; therefore, Rabbit Polyclonal to OR6Q1 adding an SGLT2 inhibitor can Oseltamivir phosphate (Tamiflu) assist in not only improving glycemic control but also reducing glycemic fluctuations. Although adding an SGLT2 inhibitor to insulin may increase the risk of hypoglycemia, the potential to reduce the need for increasing insulin doses may moderate this effect. Patients with type 1 diabetes uncontrolled with insulin therapy who are overweight/obese and have hypertension may benefit from the addition of an SGLT2 inhibitor because these medications help to lower A1C values and can reduce both weight and blood pressure. Several studies have demonstrated reductions in A1C, weight, and blood pressure in patients with type 1 diabetes on either canagliflozin or empagliflozin, another SGLT2 inhibitor. These clinical trials showed A1C reductions in the range of 0.25C0.4% (5C9) and weight loss ranging from 2.1 to 4.2 kg (5,7,9). Systolic blood pressure (SBP) was found to be reduced by 7.9 mmHg in one study (9). Although controlled studies have reported outcomes for patients with type 1 diabetes on canagliflozin, the present study is unique in examining real-world outcomes in an actual clinical practice in a small group of patients receiving care in a specialty diabetes clinic. The purpose of this study was to determine clinical outcomes, mainly A1C, and characteristics of patients with type 1 diabetes prescribed canagliflozin in a specialty clinic, the Iowa Diabetes and Endocrinology Center (IDEC). There are currently few data available regarding the use of canagliflozin in this specific patient population, and the studies that exist are small clinical trials. This study examined actual use of canagliflozin in clinical practice because the authors wanted to see how outcomes compared to those in randomized controlled trials. Methods This study was a retrospective electronic medical record (EMR) (Centricity; GE Healthcare, Barrington, IL) review of all patients with type 1 diabetes prescribed canagliflozin by IDEC providers from June 2013 to June 2015. The study was designed to report on canagliflozin because it was the only FDA-approved SGLT2 inhibitor available in the United States at the beginning of the study Oseltamivir phosphate (Tamiflu) period. Patients were referred to this clinic by local or regional providers for management of advanced diabetes and complications. An inquiry of Centricity was conducted during July 2015 to search for all patients with type 1 diabetes within the clinic who were prescribed canagliflozin. All patients were de-identified through the assignment of unique study numbers to ensure that Health Insurance Portability and Accountability Act (HIPAA) of 1996 requirements were met. Patients meeting inclusion criteria had a diagnosis of type 1 diabetes, were at least 18 years old, received regular care at the clinic, received their initial canagliflozin prescription (index date) from a clinic prescriber, returned for a minimum of two follow-up office visits after the canagliflozin index date, and had a baseline estimated glomerular filtration rate (eGFR) 45 mL/min for a starting dose of 100 mg or eGFR 60 mL/min for a starting dose of 300 mg (as recommended in the package insert). Patients were excluded if they were not receiving canagliflozin continuously from the index date to the second follow-up office visit for reasons such as presumed tolerability or efficacy issues, patient-volunteered nonadherence, or if the patients dose was changed between the index date and second follow-up office Oseltamivir phosphate (Tamiflu) visit. Baseline characteristics extracted through the EMR for the index day included sex, age group, duration of diabetes (years), kind of insulin therapy, A1C, BMI, pounds Oseltamivir phosphate (Tamiflu) (kg), SBP, diastolic blood circulation pressure (DBP), and dosage of Oseltamivir phosphate (Tamiflu) canagliflozin (either 100 or 300 mg through the entire entire research period). Initial and second follow-up workplace visits were thought as the 1st and second period the patient came back towards the diabetes center following the index day. Values recorded for every follow-up office check out included A1C, BMI, pounds, SBP,.