Should you hesitate to start #Flozins higher when sugars too high? Here’s that idea debunked in a propensity score matched analysis in JAMA IM

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2800884

Efficacy maintained and AEs consistent across HgbA1c strata (and all favouring Flozins except genital infxn)

Any comments @mike_johansen @ChristosArgyrop @Bneuen ?

There will likely be a generic #flozin in the US next year. There are already generic #flozins #sglt2i available in many countries that do not even have the costs used in this simulation, and thus the results don't apply to them. So, while the calculations are likely to become irrelevant in the US very soon, the paper will be used to restrict access to these drugs through formularies in many locales.
https://jamanetwork.com/journals/jamacardiology/fullarticle/2802216?utm_source=twitter&utm_campaign=content-shareicons&utm_content=article_engagement&utm_medium=social&utm_term=030523#.ZATGQTbUGiE.twitter

The next edition of #NephTrials on master trial protocols, with a focus on #BasketTrials using the #RENALLIFECYCLES example http://www.nephjc.com/news/master-trials in #Flozins

With a great #VisualAbstract from Denisse Arellano from the ISN social media team

http://www.nephjc.com/news/master-trials

Don't be an ageist prescriber when it comes to #flozins. They work equally well in older v.s. younger individuals for all outcomes (Heart Failure - HHF, Major cardiovascular events - MACE, or composite cardiac/renal -CRC)

This is from a webinar I gave through the American Society of Nephrology about the anticipated effects of SGTL2 inhibitors #flozins on the incidence (number of new starts) of End Stage Kidney Disease *pre covid* #flozinator

Sick day rules and #Flozins

Detailed contrarian review and good discussion of #SGLT2i use during hospitalization https://pubmed.ncbi.nlm.nih.gov/35801339/ (gated)

Given the benefit: the authors suggest continuing Flozins and doing daily glucose + ketones testing

@ChristosArgyrop & @mike_johansen for thoughts?
See their algorithm:

So much information in the supplement of the #Fidelity meta-analysis
https://academic.oup.com/eurheartj/article/43/6/474/6433104?login=false#supplementary-data
➡️This the risk profile of the participants I treat.
➡️It does not matter what their characteristics are, or whether they take other drugs #flozins #GLP1RA.
#Finerenone works the same!
#nephmastodon #endomastodon #cardiomastodon
#ckd #diabetes #cvd

https://www.ncbi.nlm.nih.gov/books/NBK576405/
Statpearls entry about #flozins Sodium Glucose contransporter 2 inhibitors.
Is it in need of updating after #EMPAKIDNEY ?

@GordFogg I have a love/hate relationship with #Flozins
Fantastic drugs for non-diabetes indications.
Those extend to #PWD too, but the level of #Diabetes risk assessment, sick day rules & clinical backup from /some prescribers/ does result in me seeing more potentially avoidable euglycaemic DKA than I'd like.
I have an SGLT2i+HF MDT with my #cardiology colleagues, which is great.
@nick

Big #GLP1ra week in the #Nephrology clinic for me and my patients. Not a lot of experience with them yet, but no time like the present to start, especially when the #Flozins are already on-board! :smile_animated:

@hswapnil @mike_johansen This is cool! We are working on medication specific guidelines to harmonize prescriptions of #Flozins, #GLP1ra, #nsMRA etc across #primarycare, #cardiology, #endocrinology and #nephrology, which has been a fun project. I think at our institution, nephrology prescribed most aggressively, but that is probably the effect of having Amy Mottl in our division.

@EvanZeitler @mike_johansen we made this in Ontario https://www.ontariorenalnetwork.ca/en/kidney-care-resources/clinical-tools/primary-care-tools/kidneywise/toolkit
(We = Scott Brimble, #Nephrologist Allan Grill #familymedicine & team)
- need to add #Flozins etc