Euglycemic Diabetic Ketoacidosis: A Potential Complication of Treatment With Sodium–Glucose Cotransporter 2 Inhibition
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Discussion
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Implication
Clinical review reports euglycemic diabetic ketoacidosis in patients receiving SGLT-2 inhibitors, highlighting the need for prompt ketone monitoring and caution in type 1 diabetes.
Key Points
- To review the association between sodium-glucose cotransporter 2 (SGLT-2) inhibitor therapy and the development of euglycemic diabetic ketoacidosis and ketosis.
- Assessed clinical presentations and proposed pathophysiological mechanisms of euglycemic diabetic ketoacidosis in patients with type 1 or type 2 diabetes receiving SGLT-2 inhibitors.
- SGLT-2 inhibitor use is linked to euglycemic diabetic ketoacidosis and ketosis, potentially driven by noninsulin-dependent glucose clearance, hyperglucagonemia, and volume depletion.
- Prompt evaluation of urine or serum ketones is indicated for patients on SGLT-2 inhibitors who present with nausea, vomiting, malaise, or metabolic acidosis.
- Use of SGLT-2 inhibitors in type 1 diabetes warrants strict caution, extensive patient counseling, and close clinical monitoring.
Cite This Study
Peters et al. (2015) studied this question.