• Endocr Pract · Apr 2017

    Letter Case Reports

    DIABETIC KETOACIDOSIS IN PATIENTS WITH TYPE 2 DIABETES RECENTLY COMMENCED ON SGLT-2 INHIBITORS: AN ONGOING CONCERN.

    • Mohamed Ahmed, Malachi J McKenna, and Rachel K Crowley.
    • Endocr Pract. 2017 Apr 2; 23 (4): 506-508.

    ObjectiveSodium-glucose cotransporter 2 (SGLT-2) inhibitors are increasingly used as an adjunctive treatment for type 2 diabetes. We report the occurrence of diabetic ketoacidosis (DKA) in 3 patients with type 2 diabetes recently commenced on SGLT-2 inhibitors.MethodsClinical presentation, laboratory data, and treatment outcomes of all 3 cases are described.ResultsAll 3 patients had documented history of longstanding type 2 diabetes. The presentation in all patients was that of hyperglycaemia, acidosis, and ketosis occurring within 4 weeks of commencing SGLT-2 inhibitors. The risk factors for developing DKA were infection, myocardial infarction, and alcohol excess. DKA resolved within 24 hours of initiating intravenous fluids and insulin in all cases.ConclusionThis case series illustrates the importance of careful patient selection, education, and monitoring when starting this group of antidiabetic medications.AbbreviationsDKA = diabetic ketoacidosis SGLT-2 = sodium-glucose cotransporter 2 T2D = type 2 diabetes.

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