Clinical and biochemical characteristics and analysis of risk factors for euglycaemic diabetic ketoacidosis in type 2 diabetic individuals treated with SGLT2 inhibitors: A review of 72 cases over a 4.5-year period

N Menghoum; P Oriot; M P Hermans

doi:10.1016/j.dsx.2021.102275

Clinical and biochemical characteristics and analysis of risk factors for euglycaemic diabetic ketoacidosis in type 2 diabetic individuals treated with SGLT2 inhibitors: A review of 72 cases over a 4.5-year period

Diabetes Metab Syndr. 2021 Nov-Dec;15(6):102275. doi: 10.1016/j.dsx.2021.102275. Epub 2021 Sep 15.

Authors

N Menghoum¹, P Oriot², M P Hermans³

Affiliations

¹ Department of Internal Medicine, Mouscron Hospital Center, Avenue de Fécamp 49, 7700, Mouscron, Belgium; Pole of Cardiovascular Research, Institute of Experimental and Clinical Research, Catholic University of Louvain, 1200, Brussels, Belgium.
² Department of Internal Medicine, Mouscron Hospital Center, Avenue de Fécamp 49, 7700, Mouscron, Belgium; Department of Diabetology, Mouscron Hospital Centre, Avenue de Fécamp 49, 7700, Mouscron, Belgium. Electronic address: p.oriot@chmouscron.be.
³ Endocrinology & Nutrition Unit, Cliniques Universitaires St-Luc, and Pole of Cardiovascular Research, Institute of Experimental and Clinical Research, Catholic University of Louvain, Avenue Hippocrate 55, 1200, Brussels, Belgium.

PMID: 34562870
DOI: 10.1016/j.dsx.2021.102275

Abstract

Background and aims: To study euglycemic diabetic ketoacidosis (euDKA) outcomes associated with sodium-glucose co-transporter 2 inhibitors (SGLT2is) METHODS: Review of 72 euDKA cases in T2DM between September 2015 and January 2020 (PUBMED).

Results: euDKA could occur at any time during SGLT2is treatment, with nausea, abdominal pain and vomiting as main symptoms. Hyperglycemia did not correlate with pH and β-hydroxybutyrates. Low pH and high β-hydroxybutyrates were significantly associated with euDKA. In biguanides users, acidosis was unrelated to lactic acidosis. euDKA occurred during fasting, surgery, acute infection, insulin deprivation (endogenous or exogenous).

Conclusions: These data support avoidance of euDKA risk states in SGLT2i users.

Keywords: Diabetes mellitus; Diabetic ketoacidosis; Euglycemia; SGLT-2 inhibitors; Sodium-glucose transporter 2 inhibitors; Type 2 diabetes mellitus.

Publication types

Review

MeSH terms

Blood Glucose / analysis*
Diabetes Mellitus, Type 2 / drug therapy*
Diabetes Mellitus, Type 2 / pathology
Diabetic Ketoacidosis / chemically induced
Diabetic Ketoacidosis / pathology*
Humans
Risk Factors
Sodium-Glucose Transporter 2 Inhibitors / adverse effects*

Substances

Blood Glucose
Sodium-Glucose Transporter 2 Inhibitors