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Diabetes Management and Research / Diabetes Treatment and Management / Diabetes and Associated Disorders · Journal article
Diabetes Care · September 3, 2026
A consensus or society position rather than new primary data.
This is an expert consensus statement, not a trial or meta-analysis. It proposes that mechanisms of SGLT inhibitor efficacy in type 2 diabetes and nondiabetic populations are likely applicable to type 1 diabetes, and recommends a regulatory pathway using surrogate endpoints and DKA risk mitigation protocols rather than traditional event-based outcomes. The statement acknowledges that rigorous data on DKA risk mitigation effectiveness are lacking.
Journal article. People with type 1 diabetes at risk for heart and kidney disease; perspective informed by comparison to type 2 diabetes and nondiabetic populations.
Mechanisms driving SGLT inhibitor efficacy for heart and kidney disease in T2D and nondiabetic disease are likely applicable to T1D Registrational trials in T1D may rely on suitable surrogate endpoints rather than event-based outcomes for feasibility DKA risk mitigation protocols have been developed but rigorous effectiveness data are lacking
No new efficacy or safety data reported; expert inference from other populations
This statement offers strategic guidance for designing future trials of SGLT inhibitors in type 1 diabetes and highlights the critical gap in evidence for DKA risk mitigation. Clinicians should recognise that current data supporting SGLT inhibitors in type 1 diabetes for heart and kidney disease remain limited and that safety protocols for DKA require rigorous validation before widespread clinical adoption.
Expert consensus perspective on SGLT inhibitor use in type 1 diabetes, outlining mechanisms, trial design recommendations, and safety requirements rather than presenting new clinical trial data.
This statement offers strategic guidance for designing future trials of SGLT inhibitors in type 1 diabetes and highlights the critical gap in evidence for DKA risk mitigation. Clinicians should recognise that current data supporting SGLT inhibitors in type 1 diabetes for heart and kidney disease remain limited and that safety protocols for DKA require rigorous validation before widespread clinical adoption.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
What is missing. This record has no reported figures. That is a gap in the analysis, not a judgement about the study.
Developing a path forward for sodium-glucose cotransporter (SGLT) inhibitor treatment for heart and kidney disease in people with type 1 diabetes (T1D) is essential. This article offers the perspective of experts from the fields of endocrinology, nephrology, and cardiology on available data for the efficacy and safety of SGLT inhibitors in T1D, how the far more extensive data from people with type 2 diabetes (T2D) and people without diabetes would be expected to translate to T1D, and what steps are required to advance toward regulatory approvals and clinical uptake of SGLT inhibitors in T1D for heart and kidney disease. Our conclusion is that the mechanisms driving efficacy of SGLT inhibitors for heart and kidney disease in T2D and nondiabetic disease are likely applicable to T1D and that in light of the data supporting efficacy in these populations, registrational trials in T1D might not require powering for traditional event-based outcomes and investigators may instead rely on suitable surrogate end points, allowing for more feasible trials. Investigators in these trials must also carefully collect data associated with diabetic ketoacidosis (DKA), the critical risk of SGLT inhibitor use in T1D. DKA risk mitigation is essential for SGLT inhibitor use in T1D; protocols to mitigate risk have been developed, but rigorous data on their effectiveness are lacking. We describe a roadmap to advance SGLT inhibitors for T1D heart and kidney disease, which includes the use of feasible trial designs based on surrogate end points and rigorous safety protocols to minimize DKA events.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.