An increased risk of diabetic ketoacidosis (DKA), a safety concern that wasn't understood or considered important five years ago, was largely responsible for the FDA's Endocrinologic and Metabolic Drugs Advisory Committee (EMDAC) 8-8 vote Thursday on recommending approval of Zynquista, a dual SGLT1 and SGLT2 inhibitor, as an adjunct to insulin in treating type 1 diabetes (T1D).