For type 1 diabetes patients with inadequate glycemic control, one treatment option is to increase the insulin dose (scenario 1), which should not give rise to a "metabolic imbalance." A second option is additional treatment with a sodium-glucose cotransporter 2 inhibitor, which might lead to a "metabolic imbalance" (scenario 2). A reduction in insulin dose in addition to administration of a sodium-glucose cotransporter 2 inhibitor might further increase the "metabolic imbalance" (scenario 3).
© 2019 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.