The addition of mealtime insulin to a patient’s diabetes regimen can definitely increase the risk of hypoglycemia. This can be exacerbated if the patient is not counting carbs or doing before-meal glucose checks.
This month in our special edition we look at the value of using an SGLT-2 Inhibitor instead of meal time insulin in patients with type 2 diabetes. This article can be backed up by the information from the package insert of canagliflozin, which indicates that 100 grams of glucose can be off loaded through the kidneys on a daily basis.
If I look back to my pump training days, for an obese patient we would likely use an insulin to carb ratio of 1 unit for every 6 carbs. Is it possible to use this formula to state that taking an SGLT-2 Inhibitor like canaglifozin can reduce insulin use by 16- 17 units in a similar patient? Let me know what you think?