SGLT-2 inhibitors induce hypernatremia and euDKA through multiple biological mechanisms, including osmotic diuresis. Because euDKA is characterized by ketoacidosis occurring in the absence of marked hyperglycemia, its diagnosis is often delayed or overlooked. Therefore, it is crucial to recognize the potential risk of these complications when prescribing SGLT-2 inhibitors in the perioperative setting of cardiac surgery. Based on our findings, we recommend discontinuing SGLT-2 inhibitors during the perioperative period.
Bian et al. (Fri,) studied this question.