Invokana has been recommended by an internist (for a Type 1 diabetic who is very insulin sensitive and is on very small doses of insulin) for use in conjunction with twice X daily injections of Lantus and with no further use of short acting insulin. Has anyone heard of such therapy? Invokana has been generally deemed as a Type 2 medication that has shown good results. Are there any ideas about this out there about the use of Invokana in Type 1?
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Invokana
- Thread starter beteg
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Daibell
Master
Interesting. I had not heard of Invokana until I just googled it. The web info says it's not to be used for T1 but I have no knowledge of it's use in practice. Many diabetics on insulin would just have daily Basal (split if needed) and no or very low Bolus insulin if very insulin sensitive. I wonder why the internist wants to avoid low or nil Bolus? It's not for me as an amateur to guess.
phoenix
Expert
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- Type of diabetes
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Invokana :canaglifozin seems to work in the same way as Forxiga. I wrote about this the other day.
Transporters are used for some molecules to pass through a cell membrane into and out of a cell. Sodium glucose transporters are co transporters. The glucose 'piggybacks' with the sodium .
These particular co transporters occur in the kidney (and in the intestine) In the kidneys, they are there to reabsorb glucose, enabling it to be returned to the circulation and to be used rather than being excreted out into the urine ie it is an energy saving mechanism stopping the loss of glucose.
If the transporter is inhibited, as is done by this drug,then some of the excess glucose will excreted rather than put to reuse. ( ?? presumably some sodium will also be excreted which should be beneficial if you have high blood pressure)
There is a video on the manufacturers site which I've just found which describes this (and then goes to read out all the results from trials) http://www.invokanahcp.com/mechanism-of-action
So basically you pee out excess glucose rather than the body recycling it for use. Normally the kidneys only get rid of it through the urine when there is too much glucose for the reabsorption system to cope with . That occurs at about 180mg/dl (10mmol/l). Presumably with this drug then would get rid of some glucose at a lower level
There is an interesting article on this sort of drugs possible use in T1 in the blog Diabetes Mine http://www.diabetesmine.com/2014/04/t2-diabetes-pee-drug-for-type-1.html
Apparently there has been some research on their use in T1 at Joslin and in a formal trial in Toronto. Apparently diabetes educator and T1 G Scheiner has been trying it out for himself.
Transporters are used for some molecules to pass through a cell membrane into and out of a cell. Sodium glucose transporters are co transporters. The glucose 'piggybacks' with the sodium .
These particular co transporters occur in the kidney (and in the intestine) In the kidneys, they are there to reabsorb glucose, enabling it to be returned to the circulation and to be used rather than being excreted out into the urine ie it is an energy saving mechanism stopping the loss of glucose.
If the transporter is inhibited, as is done by this drug,then some of the excess glucose will excreted rather than put to reuse. ( ?? presumably some sodium will also be excreted which should be beneficial if you have high blood pressure)
There is a video on the manufacturers site which I've just found which describes this (and then goes to read out all the results from trials) http://www.invokanahcp.com/mechanism-of-action
So basically you pee out excess glucose rather than the body recycling it for use. Normally the kidneys only get rid of it through the urine when there is too much glucose for the reabsorption system to cope with . That occurs at about 180mg/dl (10mmol/l). Presumably with this drug then would get rid of some glucose at a lower level
There is an interesting article on this sort of drugs possible use in T1 in the blog Diabetes Mine http://www.diabetesmine.com/2014/04/t2-diabetes-pee-drug-for-type-1.html
Apparently there has been some research on their use in T1 at Joslin and in a formal trial in Toronto. Apparently diabetes educator and T1 G Scheiner has been trying it out for himself.
