Predisposing factors for the development of diabetic ketoacidosis with lower than anticipated glucose levels in type 2 diabetes patients on SGLT2-inhibitors: a review

Bamgboye, Adeboye Olakunle; Oni, Isaac Oluwadamilare; Collier, Andrew

doi:10.1007/s00228-020-03051-3

Cited by 32 publications

(18 citation statements)

References 61 publications

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“…The onset of EDKA was recognized between POD 0 [withhold of SGLT2-I for 48 h prior to surgery ( 38 )] and 6 weeks after [under SGLT2-I intake ( 1 )] surgery, hence, reflecting a wide range of clinical presentation. Reported patients were between 42 ( 31 ) and 76 ( 2 ) years of age, were prescribed empagliflozin ( 2 , 33 , 37 – 45 , 47 – 50 , 55 ), ertugliflozin ( 53 ), canagliflozin ( 2 , 31 – 33 , 35 , 36 , 49 , 54 ), or dapagliflozin ( 1 , 27 , 35 , 41 , 46 , 51 , 54 ), and female gender was an assumed risk factor ( 56 ). A long history of diabetes duration (>10 years) and the use of oral antidiabetics with or without insulin application were reported as predisposing patients' characteristics ( 57 ).…”

Section: Resultsmentioning

confidence: 99%

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New Diabetic Medication Sodium-Glucose Cotransporter-2 Inhibitors Can Induce Euglycemic Ketoacidosis and Mimic Surgical Diseases: A Case Report and Review of Literature

Kietaibl¹,

Fasching²,

Glaser³

et al. 2022

Front. Surg.

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BackgroundEuglycemic diabetic ketoacidosis (EDKA) is a potentially life-threatening condition and a reported side effect of antidiabetic sodium-glucose-cotransporter-2-inhibitors (SGLT2-I). The analysis of the herein presented case and its management formed the incentive to prepare this multidisciplinary work and includes an overview about perioperative SGLT2-I-induced ketoacidosis.MethodA PubMed search on relevant entries was conducted combining the terms “euglycemic diabetic ketoacidosis” AND “surgery.”ResultsA total of 33 articles on SGLT2-I-induced ketoacidosis in the context of surgical treatment were identified. According to this literature research risk factors for the development are infection, perioperative fasting, surgical stress, and insulin dose reduction.ConclusionUnspecific symptoms mimicking acute abdomen and normoglycemia can lead to delayed diagnosis of EDKA and might harm patients under SGLT2-I therapy in the perioperative setting. SGLT2-I medication should be withheld for at least 24–48 h prior to surgery according to this review of literature and restarted only in stable clinical conditions to avoid the severe complication of EDKA.

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Section: Resultsmentioning

confidence: 99%

“…History of SGLT2-I-induced EDKA must be added to the patient's allergy chart ( 36 , 61 ). Patients need to be aware of the potential side effects in predisposing situations and be able to follow “sick day rules” ( 36 , 56 , 59 ).…”

Section: Resultsmentioning

confidence: 99%

New Diabetic Medication Sodium-Glucose Cotransporter-2 Inhibitors Can Induce Euglycemic Ketoacidosis and Mimic Surgical Diseases: A Case Report and Review of Literature

Kietaibl¹,

Fasching²,

Glaser³

et al. 2022

Front. Surg.

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“…Other studies have revealed that risk factors for euDKA with SGLT‐2i include low carbohydrate diets, insulin withdrawal or dose reduction, dehydration, a low reserve of insulin‐secreting cells, stress, surgery, infection, and acute medical illness, which were similar to conventional DKA 8,15,16 . Moreover, the heterogeneous expression of SGLT‐2 receptor probably contributes to different responses in patients taking SGLT‐2i 17 . Considering the present patient taking four antidiabetic drugs, poorly controlled diabetes was the primary factor underlying DKA.…”

Section: What Is New and Conclusionmentioning

confidence: 99%

Sodium‐glucose cotransporter‐2 inhibitor‐induced euglycemic diabetic ketoacidosis: A case report

Han

Xie

Jiao

2022

Clinical Pharmacy Therapeu

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“…Particularly relevant for individuals with FRDA is the increased incidence of euglycemic diabetic ketoacidosis with SGLT2 inhibitor use. 87 Finally, in FRDA related diabetes, glycemic targets should be individualized, and screening for complications as in other forms of diabetes, although with attention to the overlap with complications of FRDA itself.…”

Section: Specific Care Aspectsmentioning

confidence: 99%

Friedreich Ataxia: Multidisciplinary Clinical Care

Lynch¹,

Schadt²,

Kichula³

et al. 2021

JMDH

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Friedreich ataxia (FRDA) is a multisystem disorder affecting 1 in 50,000–100,000 person in the United States. Traditionally viewed as a neurodegenerative disease, FRDA patients also develop cardiomyopathy, scoliosis, diabetes and other manifestation. Although it usually presents in childhood, it continues throughout life, thus requiring expertise from both pediatric and adult subspecialist in order to provide optimal management. The phenotype of FRDA is unique, giving rise to specific loss of neuronal pathways, a unique form of cardiomyopathy with early hypertrophy and later fibrosis, and diabetes incorporating components of both type I and type II disease. Vision loss, hearing loss, urinary dysfunction and depression also occur in FRDA. Many agents are reaching Phase III trials; if successful, these will provide a variety of new treatments for FRDA that will require many specialists who are not familiar with FRDA to provide clinical therapy. This review provides a summary of the diverse manifestation of FRDA, existing symptomatic therapies, and approaches for integrative care for future therapy in FRDA.

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Predisposing factors for the development of diabetic ketoacidosis with lower than anticipated glucose levels in type 2 diabetes patients on SGLT2-inhibitors: a review

Cited by 32 publications

References 61 publications

New Diabetic Medication Sodium-Glucose Cotransporter-2 Inhibitors Can Induce Euglycemic Ketoacidosis and Mimic Surgical Diseases: A Case Report and Review of Literature

New Diabetic Medication Sodium-Glucose Cotransporter-2 Inhibitors Can Induce Euglycemic Ketoacidosis and Mimic Surgical Diseases: A Case Report and Review of Literature

Sodium‐glucose cotransporter‐2 inhibitor‐induced euglycemic diabetic ketoacidosis: A case report

Friedreich Ataxia: Multidisciplinary Clinical Care

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