Ketosis-Prone Type 2 Diabetes

Umpiérrez, Guillermo E.

doi:10.2337/dc06-1870

Cited by 81 publications

(61 citation statements)

References 45 publications

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“…Table 1 summarizes an approximation of clinical risk predicted from a crude estimate of beta-cell capacity for insulin secretion by means of the C-peptide assay. 33 An incidence of 1.34 per 1,000 person years has been reported by Danish investigators based on a review of national registries. 34 In summary, if glucose release in the proximal tubule persists, then ketoacidosis can occur at relatively normal blood glucose concentrations, and if dehydration proceeds to a level of decreased kidney clearance of glucose and ketones, then hyperglycemic ketoacidosis may occur without detection of urine ketones.…”

mentioning

confidence: 99%

Sodium–glucose cotransporter-2 inhibition and acidosis in patients with type 2 diabetes: a review of US FDA data and possible conclusions

D’Elia

Segal

Bayliss

et al. 2017

IJNRD

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Objective: To evaluate whether adverse event reports to the US Food and Drug Administration on incidents of ketoacidosis from use of sodium glucose cotransport inhibitors (SGLT2 inhibitors) provide insight into ways this new class of drugs is being prescribed with other antihyperglycemic agents; to examine possible mechanisms to explain ketoacidosis. Design and methods: Reports of adverse events concerned to SGLT2 inhibitors, namely, empagliflozin, dapagliflozin, and canagliflozin were obtained under the Freedom of Information Act for 5 years ending in August 31, 2015. The data were evaluated for incidents of ketoacidosis by looking for keywords such as diabetic ketoacidosis, ketoacidosis, lactic acidosis, acidosis, and metabolic acidosis. Results were tabulated individually for empagliflozin (n=260 adverse event reports), dapagliflozin (n=520), and canagliflozin (n=2159). Adverse events were categorized according to age, gender, and insulin use. Results: There were 46, 144, and 450 reports of ketoacidosis concerned with the use of empagliflozin, dapagliflozin, and canagliflozin, respectively. The use of SGLT2 inhibitors was not strictly limited to patients with type 2 diabetes but was cut across categories of insulin use, including a total of 172 cases of SGLT2-related ketoacidosis in individuals above the age of 40 who were not on insulin. Conclusion:Further studies should focus to detect pleiotropic effects of SGLT2 inhibitors, particularly with other oral antihyperglycemic drugs or insulin. A review of the literature suggests that patients with type 2 diabetes with low C-peptide level may be at increased risk of ketoacidosis, particularly if they are on statins and diuretics due to hypokalemia and impaired release of insulin. More studies are warranted to further clarify these mechanisms.

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confidence: 99%

Sodium–glucose cotransporter-2 inhibition and acidosis in patients with type 2 diabetes: a review of US FDA data and possible conclusions

D’Elia

Segal

Bayliss

et al. 2017

IJNRD

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“…Este subtipo de DM es una entidad clínica única, no incorporada aún en la clasificación actual de la American Diabetes Association (ADA) , existiendo posteriormente numerosas publicaciones al respecto 4,5 . Esta variante de DM2 se había denominado diabetes atípica, diabetes intermedia, DM 1,5 o "Flatbush diabetes".…”

Section: Discussionunclassified

“…Nosotros publicamos en el año 2001 un grupo de pacientes que correspondería a este subtipo de DM2 9 . Por la dificultad que presenta para algunos casos la clasificación de diabetes actualmente utilizada 10 , se ha propuesto un esquema complementario denominado Aβ 11,12 , que usa la presencia o ausencia de autoanticuerpos (A+ o A-) y de función beta celular (secreción de insulina), evaluada por péptido C, con o sin secreción (β+ o β-), que se realiza a las 3-6 semanas del cuadro agudo de CAD 4 . La mayoría de los pacientes con DTC serían (A-β+), ya que tienen reserva insulínica, pero sin autoanticuerpos, lo que los diferenciaría de los DM1 que son A+ β-.…”

Section: Discussionunclassified

Diabetes Mellitus tipo 2 con tendencia a la cetosis: Caso clínico

2015

Rev. méd. Chile

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“…30 These individuals, often of Asian or Afro-Caribbean ancestry, are characterized by relative insulin deficiency and are prone to developing diabetic ketoacidosis. 31 Despite these hybrid forms of diabetes, T2D is the major cause of diabetes worldwide and accounts for nearly 90-95% of diabetes cases. T2D by itself is also a heterogeneous disease, as patients can range from those with a predominantly insulinresistance phenotype but with sufficient ␤ cell reserve to remain insulin independent to those who may require insulin treatment early in the course of their disease.…”

Section: Precision Medicinementioning

confidence: 99%

Precision medicine in diabetes: an opportunity for clinical translation

Merino

Florez

2018

Annals of the New York Academy of Sciences

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Metabolic disorders present a public health challenge of staggering proportions. In diabetes, there is an urgent need to better understand disease heterogeneity, clinical trajectories, and related comorbidities. A pressing and timely question is whether we are ready for precision medicine in diabetes. Some biological insights that have emerged during the last decade have already been used to direct clinical decision making, especially in monogenic forms of diabetes. However, much work is necessary to integrate high-dimensional explorations into complex disease architectures, less penetrant biological alterations, and broader phenotypes, such as type 2 diabetes. In addition, for precision medicine to take hold in diabetes, reproducibility, interpretability, and actionability remain key guiding objectives. In this review, we examine how mounting data sets generated during the last decade to understand biological variability are now inspiring new venues to clarify diabetes nosology and ultimately translate findings into more effective prevention and treatment strategies.

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Ketosis-Prone Type 2 Diabetes

Cited by 81 publications

References 45 publications

Sodium–glucose cotransporter-2 inhibition and acidosis in patients with type 2 diabetes: a review of US FDA data and possible conclusions

Sodium–glucose cotransporter-2 inhibition and acidosis in patients with type 2 diabetes: a review of US FDA data and possible conclusions

Diabetes Mellitus tipo 2 con tendencia a la cetosis: Caso clínico

Precision medicine in diabetes: an opportunity for clinical translation

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Ketosis-Prone Type 2 Diabetes

Cited by 81 publications

References 45 publications

Sodium&ndash;glucose cotransporter-2 inhibition and acidosis in patients with type 2 diabetes: a review of US FDA data and possible conclusions

Sodium&ndash;glucose cotransporter-2 inhibition and acidosis in patients with type 2 diabetes: a review of US FDA data and possible conclusions

Diabetes Mellitus tipo 2 con tendencia a la cetosis: Caso clínico

Precision medicine in diabetes: an opportunity for clinical translation

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Sodium–glucose cotransporter-2 inhibition and acidosis in patients with type 2 diabetes: a review of US FDA data and possible conclusions

Sodium–glucose cotransporter-2 inhibition and acidosis in patients with type 2 diabetes: a review of US FDA data and possible conclusions