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Sgl2 inhibitors worry

dado

dado

New Member
Relationship to Diabetes
Type 2
Hi all. I’ve been taking Dapagliflozin in conjunction with metaformin for about 3 months my worry is the dangerous side effects amputations etc that they say can occur with Dapagliflozin . Anyone taking this medication have similar thoughts ?share experience have they stopped taking it thoughts welcome. My first 3 month blood test was in the non diabetic range.
 
Haven’t heard of anyone on the forum having limb problems or amputations as a result of this medication, mainly hear about urine infections and thrush as side effects, and a couple of DKA side effects.
 
dado said:
Hi all. I’ve been taking Dapagliflozin in conjunction with metaformin for about 3 months my worry is the dangerous side effects amputations etc that they say can occur with Dapagliflozin . Anyone taking this medication have similar thoughts ?share experience have they stopped taking it thoughts welcome. My first 3 month blood test was in the non diabetic range.
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I have not heard of that as a potential side effect. I am currently taking both dapagliflozin and metformin and while my metformin dose was halved some time ago and I do hope to get off both medications in time I am taking it very slowly with reducing the doses to see how it goes.

The most common side effect is urinary tract infections. Drinking plenty of water can help to counteract that potential side effect as it helps to dilute the sugar that the medication causes to be dumped into the urine. The most serious side effect that might realistically occur is Euglycemic Diabetic Ketoacidosis (DKA) - Link. This may occur if taking dapagliflozin while fasting, eating an extremely low-carb diet such as Keto, taking it while ill and so aren't eating enough or drinking enough water, or if drinking excessive amounts of alcohol.

Dapagliflozin does not generally cause hypos by itself but it can keep blood glucose levels lower for longer if they go low due to some other cause, for example during fasting or after drinking a large amount of alcohol. When blood glucose levels are slightly low for a long time the body burns a lot of fat for fuel, and this causes ketones to build up in the blood. High ketone levels in the blood are toxic but are generally flushed out of the body via the urine. For this reason I was told by my doctor to stop taking this medication if I am sick as I may not be eating or drinking enough to avoid this risk. Fasting and dehydration are both risk factors. Other than that this side-effect is extremely unlikely to occur so long as you are eating at least some carbs with each meal and do not drink large amounts of alcohol. Even with all the people out there drinking alcohol while on this medication DKA is quite rare.

One even more rare side effect is a particular type of infection. That side effect has been reported but is so rare that nobody is certain how dapagliflozin might possibly cause it or even it's there is a definite link between the medication and the infection. It might just be coincidence that a few people developed the infection while on this medication. Even then this side effect is mentioned in TV advertising for this medication in the United States as they are required to mention all serious side effects in TV advertising. They don't mention amputation and so I don't know how that could be a potential side-effect of this medication unless the infection and amputation are related. Even if they are related it's a ridiculously rare side effect, the kind that most doctors will never see in their lifetime. I personally don't worry much about it. I do take care to eat a reasonable amount of carbs if I'm drinking alcohol and if I get the flu I'll stop taking the medication, but other than that I consider it very safe.
 
PerSpinasAdAstra said:
I have not heard of that as a potential side effect. I am currently taking both dapagliflozin and metformin and while my metformin dose was halved some time ago and I do hope to get off both medications in time I am taking it very slowly with reducing the doses to see how it goes.

The most common side effect is urinary tract infections. Drinking plenty of water can help to counteract that potential side effect as it helps to dilute the sugar that the medication causes to be dumped into the urine. The most serious side effect that might realistically occur is Euglycemic Diabetic Ketoacidosis (DKA) - Link. This may occur if taking dapagliflozin while fasting, eating an extremely low-carb diet such as Keto, taking it while ill and so aren't eating enough or drinking enough water, or if drinking excessive amounts of alcohol.

Dapagliflozin does not generally cause hypos by itself but it can keep blood glucose levels lower for longer if they go low due to some other cause, for example during fasting or after drinking a large amount of alcohol. When blood glucose levels are slightly low for a long time the body burns a lot of fat for fuel, and this causes ketones to build up in the blood. High ketone levels in the blood are toxic but are generally flushed out of the body via the urine. For this reason I was told by my doctor to stop taking this medication if I am sick as I may not be eating or drinking enough to avoid this risk. Fasting and dehydration are both risk factors. Other than that this side-effect is extremely unlikely to occur so long as you are eating at least some carbs with each meal and do not drink large amounts of alcohol. Even with all the people out there drinking alcohol while on this medication DKA is quite rare.

One even more rare side effect is a particular type of infection. That side effect has been reported but is so rare that nobody is certain how dapagliflozin might possibly cause it or even it's there is a definite link between the medication and the infection. It might just be coincidence that a few people developed the infection while on this medication. Even then this side effect is mentioned in TV advertising for this medication in the United States as they are required to mention all serious side effects in TV advertising. They don't mention amputation and so I don't know how that could be a potential side-effect of this medication unless the infection and amputation are related. Even if they are related it's a ridiculously rare side effect, the kind that most doctors will never see in their lifetime. I personally don't worry much about it. I do take care to eat a reasonable amount of carbs if I'm drinking alcohol and if I get the flu I'll stop taking the medication, but other than that I consider it very safe.
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Thanks very much for the info
 
I have been taking dapagliflozin along with metformin since the beginning of the year and can only report that the dapagliflozin halted a steadily increasing blood glucose with no side effects whatsoever.

My thought for you (and anybody else) is to beware of this mysterious "they" who predict doom and gloom about almost anything and everything.
 
@Docb I have been taking dapaglifozin since September and it has knocked me off course. I could do with losing 15 kg and had already lost more than 10 between diagnosis in July and getting dapaglifozin in September. I keep adding carbs when I don't want or need them as concerned about ketoacidosis. I'm considering going back to 100 to 130 mainly higher number and when visiting cafes 140 ish. When you say you are medium carb do you count carbs and is the goal maintaining weight and steady BG?
I was on oral steroids for a fortnight which has also knocked me off track. I do still want a steady weight loss. Was losing 2lbs a week but 1lb would be ok.
 
Hi @saffron15. Medications can effect people differently as shown by our differing experiences of dapagliflozin. My comment was based on the idea that the vast majority of people do not have problematic side effects otherwise the medications would not be licenced. Very few, if any, have the sort of side effects worrying @dado and it is best not to listen to those who suggest that there are.

I don't count carbs as such but I know where the carbs are. I eat three meals a day which I know will give me around 130 g carbs. In the early days I found by checking with my meter those things that were a particular problem (basically anything primarily made of wheat flour) and got to be fairly disciplined in reducing the amount I ate. When I go to a cafe I will have a cup of tea (hardly any carbs) but not have a cake (lots of carbs). I don't eat snacks (lots of carbs). My goal is maintaining a steady weight and keeping my BG averaging 8 or thereabouts.
 
dado said:
Hi all. I’ve been taking Dapagliflozin in conjunction with metaformin for about 3 months my worry is the dangerous side effects amputations etc that they say can occur with Dapagliflozin . Anyone taking this medication have similar thoughts ?share experience have they stopped taking it thoughts welcome. My first 3 month blood test was in the non diabetic range.
Click to expand...
Absolutely no thoughts of that, I’m no longer taking SGL-2 inhibitors
of which I think Dapagiflozine is one ? when I was taking one I was sent a document to ensure I was aware of the risks, I’ve still got it in the NHS app but can’t share it on here (but there’s nothing about what you refer to)
like any meds, yes there will be possible side effects and risks, for me it was a slightly un-desirable infection that meant I was visiting the little boys room over 20 times a day (despite my sugars being already low)

we all will react differently to different medications

It’s like Metformin
which I’ve been taking for over 30 years and never had the side effects so many people refer to.

poorly controlled diabetes can as we all know, lead to amputations (amongst many other complications)
in-fact my father (back in the late 90’s) lost half a leg, following a foot infection
then finally died in the year 2000 of what the doctors described to us as multiple organ failure
 
I don't know what side effects I may be having. I started a cold a week after starting the drug but it progressed like a cold sore throat lots of snot causing me to cough. Second week first ever sinusitis. It gradually got better and when I went to doctor was told were taking up to 6 weeks to clear ( first time I've ever met my doctor was due to start steroids in advance of an eye op and d didn't want to start if cold caused cancellation) I assume reference to amputations is because it can happen due to circulation problems but I would have thought the drug makes it less likely than other medications taken for diabetes and it is also used for patients with heart failure, However I still have a blocked nose and see cold/ blocked nose can be a side effect.
@Docb thank you for the reply. I am keen to reduce my carbs but worried about eating too few. Before I was placed on steroids which ramped up my appetite I was often planning three meals and getting to the evening and not wanting to eat.
Only became a problem when trying to keep carbs to 130 +
 
I'm on empagliflozin, which is another drug in the same class. I've been on it 18 months, and have had no side effects to note, other than going to the loo a bit more than previously, and being more thirsty, but that is to be expected given how they work. I've even been able to lose more weight than ever before (I always used to struggle to lose weight, now it's dropping much more easily). I get more side effects from the metformin which I'm also on, and would love to get rid of, but need to get hba1c down first before docs will even entertain it. Only side effects flagged by my GP to watch out for were DKA, particularly if not well (in which case to pause it), and the risk of UTI.

I would have thought amputation is a side effect of diabetes itself, rather than of the medicines, indeed, the medicines should reduce the risk by getting things under control.
 
I took my fasting blood glucose reading this morning and it came back 6.7. I know I had a couple of tea with milk but no sugar beforehand would that have affected the result?
 
dado said:
I took my fasting blood glucose reading this morning and it came back 6.7. I know I had a couple of tea with milk but no sugar beforehand would that have affected the result?
Click to expand...
A bit from the carbs in the milk, it was not actually fasting, but not bad anyway.
 
dado said:
I took my fasting blood glucose reading this morning and it came back 6.7. I know I had a couple of tea with milk but no sugar beforehand would that have affected the result?
Click to expand...
It wasn’t a fasting blood glucose as you had had carbs in the milk sugars but the result was ok anyway
 
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