Diabetic Ketoacidosis as an Effect of Sodium-Glucose Cotransporter 2 Inhibitor: Real World Insights
One of the notable adverse effects of sodium-glucose cotransporter 2 (SGLT2) inhibitor is diabetic ketoacidosis (DKA) often characterized by euglycemia. In this retrospective review of patients with DKA from 2015 to 2023, 21 cases of SGLT2 inhibitorassociated DKA were identified. Twelve (57.1%) exhi...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Diabetes Association
2024-11-01
|
| Series: | Diabetes & Metabolism Journal |
| Subjects: | |
| Online Access: | http://e-dmj.org/upload/pdf/dmj-2024-0036.pdf |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850265659522416640 |
|---|---|
| author | Han-Sang Baek Chaiho Jeong Yeoree Yang Joonyub Lee Jeongmin Lee Seung-Hwan Lee Jae Hyoung Cho Tae-Seo Sohn Hyun-Shik Son Kun-Ho Yoon Eun Young Lee |
| author_facet | Han-Sang Baek Chaiho Jeong Yeoree Yang Joonyub Lee Jeongmin Lee Seung-Hwan Lee Jae Hyoung Cho Tae-Seo Sohn Hyun-Shik Son Kun-Ho Yoon Eun Young Lee |
| author_sort | Han-Sang Baek |
| collection | DOAJ |
| description | One of the notable adverse effects of sodium-glucose cotransporter 2 (SGLT2) inhibitor is diabetic ketoacidosis (DKA) often characterized by euglycemia. In this retrospective review of patients with DKA from 2015 to 2023, 21 cases of SGLT2 inhibitorassociated DKA were identified. Twelve (57.1%) exhibited euglycemic DKA (euDKA) while nine (42.9%) had hyperglycemic DKA (hyDKA). More than 90% of these cases were patients with type 2 diabetes mellitus. Despite similar age, sex, body mass index, and diabetes duration, individuals with hyDKA showed poorer glycemic control and lower C-peptide levels compared with euDKA. Renal impairment and acidosis were worse in the hyDKA group, requiring hemodialysis in two patients. Approximately one-half of hyDKA patients had concurrent hyperosmolar hyperglycemic state. Common symptoms included nausea, vomiting, general weakness, and dyspnea. Seizure was the initial manifestation of DKA in two cases. Infection and volume depletion were major contributors, while carbohydrate restriction and inadequate insulin treatment also contributed to SGLT2 inhibitor-associated DKA. Despite their beneficial effects, clinicians should be vigilant for SGLT2 inhibitor risk associated with DKA. |
| format | Article |
| id | doaj-art-a1be75cc59f7438f9c8a5cbd0aff3549 |
| institution | OA Journals |
| issn | 2233-6079 2233-6087 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Korean Diabetes Association |
| record_format | Article |
| series | Diabetes & Metabolism Journal |
| spelling | doaj-art-a1be75cc59f7438f9c8a5cbd0aff35492025-08-20T01:54:21ZengKorean Diabetes AssociationDiabetes & Metabolism Journal2233-60792233-60872024-11-014861169117510.4093/dmj.2024.00362854Diabetic Ketoacidosis as an Effect of Sodium-Glucose Cotransporter 2 Inhibitor: Real World InsightsHan-Sang Baek0Chaiho Jeong1Yeoree Yang2Joonyub Lee3Jeongmin Lee4Seung-Hwan Lee5Jae Hyoung Cho6Tae-Seo Sohn7Hyun-Shik Son8Kun-Ho Yoon9Eun Young Lee10 Division of Endocrinology and Metabolism, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, KoreaOne of the notable adverse effects of sodium-glucose cotransporter 2 (SGLT2) inhibitor is diabetic ketoacidosis (DKA) often characterized by euglycemia. In this retrospective review of patients with DKA from 2015 to 2023, 21 cases of SGLT2 inhibitorassociated DKA were identified. Twelve (57.1%) exhibited euglycemic DKA (euDKA) while nine (42.9%) had hyperglycemic DKA (hyDKA). More than 90% of these cases were patients with type 2 diabetes mellitus. Despite similar age, sex, body mass index, and diabetes duration, individuals with hyDKA showed poorer glycemic control and lower C-peptide levels compared with euDKA. Renal impairment and acidosis were worse in the hyDKA group, requiring hemodialysis in two patients. Approximately one-half of hyDKA patients had concurrent hyperosmolar hyperglycemic state. Common symptoms included nausea, vomiting, general weakness, and dyspnea. Seizure was the initial manifestation of DKA in two cases. Infection and volume depletion were major contributors, while carbohydrate restriction and inadequate insulin treatment also contributed to SGLT2 inhibitor-associated DKA. Despite their beneficial effects, clinicians should be vigilant for SGLT2 inhibitor risk associated with DKA.http://e-dmj.org/upload/pdf/dmj-2024-0036.pdfdiabetes mellitusdiabetic ketoacidosissodium-glucose transporter 2 inhibitors |
| spellingShingle | Han-Sang Baek Chaiho Jeong Yeoree Yang Joonyub Lee Jeongmin Lee Seung-Hwan Lee Jae Hyoung Cho Tae-Seo Sohn Hyun-Shik Son Kun-Ho Yoon Eun Young Lee Diabetic Ketoacidosis as an Effect of Sodium-Glucose Cotransporter 2 Inhibitor: Real World Insights Diabetes & Metabolism Journal diabetes mellitus diabetic ketoacidosis sodium-glucose transporter 2 inhibitors |
| title | Diabetic Ketoacidosis as an Effect of Sodium-Glucose Cotransporter 2 Inhibitor: Real World Insights |
| title_full | Diabetic Ketoacidosis as an Effect of Sodium-Glucose Cotransporter 2 Inhibitor: Real World Insights |
| title_fullStr | Diabetic Ketoacidosis as an Effect of Sodium-Glucose Cotransporter 2 Inhibitor: Real World Insights |
| title_full_unstemmed | Diabetic Ketoacidosis as an Effect of Sodium-Glucose Cotransporter 2 Inhibitor: Real World Insights |
| title_short | Diabetic Ketoacidosis as an Effect of Sodium-Glucose Cotransporter 2 Inhibitor: Real World Insights |
| title_sort | diabetic ketoacidosis as an effect of sodium glucose cotransporter 2 inhibitor real world insights |
| topic | diabetes mellitus diabetic ketoacidosis sodium-glucose transporter 2 inhibitors |
| url | http://e-dmj.org/upload/pdf/dmj-2024-0036.pdf |
| work_keys_str_mv | AT hansangbaek diabeticketoacidosisasaneffectofsodiumglucosecotransporter2inhibitorrealworldinsights AT chaihojeong diabeticketoacidosisasaneffectofsodiumglucosecotransporter2inhibitorrealworldinsights AT yeoreeyang diabeticketoacidosisasaneffectofsodiumglucosecotransporter2inhibitorrealworldinsights AT joonyublee diabeticketoacidosisasaneffectofsodiumglucosecotransporter2inhibitorrealworldinsights AT jeongminlee diabeticketoacidosisasaneffectofsodiumglucosecotransporter2inhibitorrealworldinsights AT seunghwanlee diabeticketoacidosisasaneffectofsodiumglucosecotransporter2inhibitorrealworldinsights AT jaehyoungcho diabeticketoacidosisasaneffectofsodiumglucosecotransporter2inhibitorrealworldinsights AT taeseosohn diabeticketoacidosisasaneffectofsodiumglucosecotransporter2inhibitorrealworldinsights AT hyunshikson diabeticketoacidosisasaneffectofsodiumglucosecotransporter2inhibitorrealworldinsights AT kunhoyoon diabeticketoacidosisasaneffectofsodiumglucosecotransporter2inhibitorrealworldinsights AT eunyounglee diabeticketoacidosisasaneffectofsodiumglucosecotransporter2inhibitorrealworldinsights |