{
  "abstract": "Background Sodium-glucose co-transporter 2 (SGLT-2) inhibitors are originally anti-diabetic agents which have also important clinical benefits in heart failure and kidney disease. Despite their widespread use, the associated risk for hypoglycaemia in the context of exercise has not been adequately studied to our knowledge.Aim To assess the risk for hypoglycaemic episodes in exercising cardiac rehabilitation patients whose pharmacological therapy included SGLT-2 inhibitors.Method 79 patients (64±11 years, females n=15, males n=64) on SGLT-2 inhibitors were identified via hospital records prior to commencing the cardiac rehabilitation exercise programme in Sandwell and West Birmingham Hospitals NHS Trust. Their blood glucose (BG) was determined before and after their initial exercise session, as part of the standard care provided. Permission to undertake this study had been obtained by the relevant department. Data is shown as average ± S.D unless otherwise indicated.Results Four patients (5%), who had pre-exercise BG < 5 mmol/L (mean BG 4.2±0.5 mmol/L), were not allowed to exercise and were not included in the subsequent analysis. Included patients were categorized into two groups; those whose post-exercise BG was above 5 mmol/L (Normal blood glucose group; NBG; N=54, 68%) or below 5 mmol/L (Low blood glucose group; LBG; N=25, 31%). The change in BG with exercise was significantly greater in the LBG compared to the NBG (LBG; 3.2±1.9 mmol/L, NBG; 1.7±1.4 mmol/L; P<0.001). Overt hypoglycaemia (<4 mmol/L) was encountered in 9 cases (11%).Conclusion This preliminary study has shown that the use of SGLT-2 inhibitors could pose a risk for hypoglycaemia in exercising cardiac patients. Further research is warranted so as to fully ascertain the risk and develop mitigating strategies.",
  "authors": [
    {
      "affiliations": [
        "Cardiac Rehabilitation, City Health Campus, Dudley Road, B18 7QH, Birmingham, UK"
      ],
      "name": "Oshin Fernandes"
    },
    {
      "affiliations": [
        "Cardiac Rehabilitation, City Health Campus, Dudley Road, B18 7QH, Birmingham, UK"
      ],
      "name": "Olivia Hudson"
    },
    {
      "affiliations": [
        "Cardiac Rehabilitation, City Health Campus, Dudley Road, B18 7QH, Birmingham, UK"
      ],
      "name": "Aaron Singh"
    },
    {
      "affiliations": [
        "School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK"
      ],
      "name": "Charlotte Wensley"
    },
    {
      "affiliations": [
        "School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK"
      ],
      "name": "Mya Biberovic"
    },
    {
      "affiliations": [
        "School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK"
      ],
      "name": "Isobel Wilson"
    },
    {
      "affiliations": [
        "School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK"
      ],
      "name": "Amelia Priddey"
    },
    {
      "affiliations": [
        "Medical School, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK"
      ],
      "name": "Derek Connolly"
    },
    {
      "affiliations": [
        "Cardiac Rehabilitation, City Health Campus, Dudley Road, B18 7QH, Birmingham, UK"
      ],
      "name": "Christos Lykidis"
    }
  ],
  "title": "P28 Ascertaining the potential for hypoglycaemia during exercise in cardiac patients on SGLT-2 inhibitors",
  "uid": "1ed883b3-1ac0-545f-b674-b7d396dbf936"
}