Abstract
Patients with type 2 diabetes may develop severe ketoacidosis. A low carb high fat (LCHF) diet is oftentimes used by these patients for weight loss purposes but is also ketogenic. Antidiabetic SGLT2 inhibitors may increase glucagon secretion and may predispose to ketoacidosis, which is normoglycemic and thus makes it more difficult to suspect. We present two cases of severe ketoacidosis in type 2 diabetes patients on LCHF diet, one of which was also on SGLT2 inhibitor therapy.
MeSH terms
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Adult
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Critical Illness
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Diabetes Mellitus, Type 2 / diet therapy*
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Diabetes Mellitus, Type 2 / drug therapy
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Diabetic Ketoacidosis / etiology*
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Diabetic Ketoacidosis / therapy
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Diet, Ketogenic / adverse effects*
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Glucagon / metabolism
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Humans
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Hypoglycemic Agents / metabolism
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Hypoglycemic Agents / therapeutic use
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Male
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Middle Aged
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Obesity / diet therapy
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Sodium-Glucose Transporter 2 / metabolism
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Sodium-Glucose Transporter 2 Inhibitors / adverse effects
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Sodium-Glucose Transporter 2 Inhibitors / therapeutic use
Substances
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Hypoglycemic Agents
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Sodium-Glucose Transporter 2
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Sodium-Glucose Transporter 2 Inhibitors
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Glucagon