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SGLT2 inhibitors: updated advice on the risk of diabetic ketoacidosis
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<blockquote data-quote="Oldvatr" data-source="post: 2313191" data-attributes="member: 196898"><p>Xigduo is a combi drug of Dapa and Metformin combined, so reducing the dose is not a simple matter. Both are available separately which would allow you to adjust doses. There are other meds around that also reduce glucose by different methods. I am just a bit twitchy about these SGLT2 ones since they seem to have more hidden surprises than most and while in the USA the FDA gives warnings about them, our NICE people seem to ignore any negative aspects and do not even give the GP's advisories. GP's do not have the time to update their knowledge base from the internet, and they are strongly discouraged against doing so by their regulatory bodies. So they prescribe according to a set of rigid guidelines enforced through NICE.</p><p></p><p>Here the endos are attached to the main hospitals and universities, and deal with metabolic disorders like thyroids and metabolism. Diabetes is not really what they cover, but some become Consultants or Specialists and sit in the Holy of Holies. You need a special referral to see one, and generally T2D and Newbies do not get to see one. I have been 30 years in the saddle of T2 and have never met one.</p></blockquote><p></p>
[QUOTE="Oldvatr, post: 2313191, member: 196898"] Xigduo is a combi drug of Dapa and Metformin combined, so reducing the dose is not a simple matter. Both are available separately which would allow you to adjust doses. There are other meds around that also reduce glucose by different methods. I am just a bit twitchy about these SGLT2 ones since they seem to have more hidden surprises than most and while in the USA the FDA gives warnings about them, our NICE people seem to ignore any negative aspects and do not even give the GP's advisories. GP's do not have the time to update their knowledge base from the internet, and they are strongly discouraged against doing so by their regulatory bodies. So they prescribe according to a set of rigid guidelines enforced through NICE. Here the endos are attached to the main hospitals and universities, and deal with metabolic disorders like thyroids and metabolism. Diabetes is not really what they cover, but some become Consultants or Specialists and sit in the Holy of Holies. You need a special referral to see one, and generally T2D and Newbies do not get to see one. I have been 30 years in the saddle of T2 and have never met one. [/QUOTE]
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SGLT2 inhibitors: updated advice on the risk of diabetic ketoacidosis
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