SGLT2 inhibitor in a type 2 diabetes mellitus patient coexisted with central diabetes insipidus following hyperosmolar hyperglycemic state
Abstract Background Central diabetes insipidus (CDI) is a rare complication following a hyperglycemic hyperosmolar state (HHS) in patients with type 2 diabetes mellitus (T2DM). The coexistence of T2DM and CDI can lead to diagnostic challenges, particularly when the patients present with persistent h...
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BMC
2025-04-01
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| Series: | BMC Endocrine Disorders |
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| Online Access: | https://doi.org/10.1186/s12902-025-01924-1 |
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| author | Shu Liu Wenqiang Chen Yanru Zhao Shaohui Ma Bingyin Shi Hui Guo |
| author_facet | Shu Liu Wenqiang Chen Yanru Zhao Shaohui Ma Bingyin Shi Hui Guo |
| author_sort | Shu Liu |
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| description | Abstract Background Central diabetes insipidus (CDI) is a rare complication following a hyperglycemic hyperosmolar state (HHS) in patients with type 2 diabetes mellitus (T2DM). The coexistence of T2DM and CDI can lead to diagnostic challenges, particularly when the patients present with persistent hypernatremia without a sense of thirst. Case presentation This case report describes a young woman with T2DM and HHS who developed persistent hypernatremia without thirst. The diagnosis of CDI was delayed until she exhibited polydipsia, consuming up to 10 L of water per day, following the administration of dapagliflozin for glucose control. Initially, the low specific gravity of urine was not evident during dapagliflozin treatment. However, after discontinuing dapagliflozin for 48 h, CDI was confirmed through a water deprivation test, which revealed polyuria with low urine specific gravity and osmolality. The patient was successfully treated with oral desmopressin. Conclusions This case highlights that SGLT2 inhibitors, such as dapagliflozin, may accelerate polyuria and alter urine osmolality by inhibiting glucose and sodium reabsorption in the proximal tubular. Therefore, it is crucial to discontinue SGLT2 inhibitors when CDI is suspected or diagnosed. |
| format | Article |
| id | doaj-art-d36f9a0695a54d93ac07b8d810fd130e |
| institution | OA Journals |
| issn | 1472-6823 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Endocrine Disorders |
| spelling | doaj-art-d36f9a0695a54d93ac07b8d810fd130e2025-08-20T02:19:57ZengBMCBMC Endocrine Disorders1472-68232025-04-012511710.1186/s12902-025-01924-1SGLT2 inhibitor in a type 2 diabetes mellitus patient coexisted with central diabetes insipidus following hyperosmolar hyperglycemic stateShu Liu0Wenqiang Chen1Yanru Zhao2Shaohui Ma3Bingyin Shi4Hui Guo5Department of Endocrinology, the First Affiliated Hospital of Xian Jiaotong UniversityDepartment of Endocrinology, the First Affiliated Hospital of Xian Jiaotong UniversityDepartment of Endocrinology, the First Affiliated Hospital of Xian Jiaotong UniversityDepartment of Medical Imaging, the First Affiliated Hospital of Xian Jiaotong UniversityDepartment of Endocrinology, the First Affiliated Hospital of Xian Jiaotong UniversityDepartment of Endocrinology, the First Affiliated Hospital of Xian Jiaotong UniversityAbstract Background Central diabetes insipidus (CDI) is a rare complication following a hyperglycemic hyperosmolar state (HHS) in patients with type 2 diabetes mellitus (T2DM). The coexistence of T2DM and CDI can lead to diagnostic challenges, particularly when the patients present with persistent hypernatremia without a sense of thirst. Case presentation This case report describes a young woman with T2DM and HHS who developed persistent hypernatremia without thirst. The diagnosis of CDI was delayed until she exhibited polydipsia, consuming up to 10 L of water per day, following the administration of dapagliflozin for glucose control. Initially, the low specific gravity of urine was not evident during dapagliflozin treatment. However, after discontinuing dapagliflozin for 48 h, CDI was confirmed through a water deprivation test, which revealed polyuria with low urine specific gravity and osmolality. The patient was successfully treated with oral desmopressin. Conclusions This case highlights that SGLT2 inhibitors, such as dapagliflozin, may accelerate polyuria and alter urine osmolality by inhibiting glucose and sodium reabsorption in the proximal tubular. Therefore, it is crucial to discontinue SGLT2 inhibitors when CDI is suspected or diagnosed.https://doi.org/10.1186/s12902-025-01924-1T2DMHyperosmolar hyperglycemic stateCentral diabetes insipidusSGLT2 inhibitors |
| spellingShingle | Shu Liu Wenqiang Chen Yanru Zhao Shaohui Ma Bingyin Shi Hui Guo SGLT2 inhibitor in a type 2 diabetes mellitus patient coexisted with central diabetes insipidus following hyperosmolar hyperglycemic state BMC Endocrine Disorders T2DM Hyperosmolar hyperglycemic state Central diabetes insipidus SGLT2 inhibitors |
| title | SGLT2 inhibitor in a type 2 diabetes mellitus patient coexisted with central diabetes insipidus following hyperosmolar hyperglycemic state |
| title_full | SGLT2 inhibitor in a type 2 diabetes mellitus patient coexisted with central diabetes insipidus following hyperosmolar hyperglycemic state |
| title_fullStr | SGLT2 inhibitor in a type 2 diabetes mellitus patient coexisted with central diabetes insipidus following hyperosmolar hyperglycemic state |
| title_full_unstemmed | SGLT2 inhibitor in a type 2 diabetes mellitus patient coexisted with central diabetes insipidus following hyperosmolar hyperglycemic state |
| title_short | SGLT2 inhibitor in a type 2 diabetes mellitus patient coexisted with central diabetes insipidus following hyperosmolar hyperglycemic state |
| title_sort | sglt2 inhibitor in a type 2 diabetes mellitus patient coexisted with central diabetes insipidus following hyperosmolar hyperglycemic state |
| topic | T2DM Hyperosmolar hyperglycemic state Central diabetes insipidus SGLT2 inhibitors |
| url | https://doi.org/10.1186/s12902-025-01924-1 |
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