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Diabetic Ketoacidosis in a Patient with Type 2 Diabetes After Initiation of Sodium-Glucose Cotransporter 2 Inhibitor Treatment.
- Source :
-
Basic & clinical pharmacology & toxicology [Basic Clin Pharmacol Toxicol] 2016 Feb; Vol. 118 (2), pp. 168-70. Date of Electronic Publication: 2015 Sep 11. - Publication Year :
- 2016
-
Abstract
- Sodium-glucose cotransporter 2 inhibitors (SGLT2i) were recently introduced for the treatment of type 2 diabetes (T2D). SGLT2i lower plasma glucose by inhibiting the renal reuptake of glucose leading to glucosuria. Generally, these drugs are considered safe to use. However, recently, SGLT2i have been suggested to predispose to ketoacidosis. Here, we present a case of diabetic ketoacidosis (DKA) developed in an obese, poorly controlled male patient with T2D treated with the SGLT2i dapagliflozin. He was admitted with DKA 5 days after the initiation of treatment with the SGLT2i dapagliflozin. On admission, the primary symptoms were nausea and dizziness, and he was hypertensive (170/103) and tachycardic (119 bpm) and had mild hyperglycaemia (15.3 mmol/l), severe ketonuria and severe metabolic acidosis (pH 7.08). He responded well to infusions of insulin, glucose and saline and was discharged after 72 hr with insulin as the only glucose-lowering therapy. After 1 month, dapagliflozin was reintroduced as add-on to insulin with no recurrent signs of ketoacidosis. During acute illness or other conditions with increased insulin demands in diabetes, SGLT2i may predispose to the formation of ketone bodies and ensuing acidosis.<br /> (© 2015 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).)
- Subjects :
- Adult
Blood Glucose analysis
Humans
Hypoglycemic Agents administration & dosage
Hypoglycemic Agents adverse effects
Kidney Tubules, Proximal drug effects
Kidney Tubules, Proximal metabolism
Male
Medication Therapy Management
Sodium-Glucose Transporter 2 metabolism
Sodium-Glucose Transporter 2 Inhibitors
Treatment Outcome
Benzhydryl Compounds administration & dosage
Benzhydryl Compounds adverse effects
Diabetes Mellitus, Type 2 complications
Diabetes Mellitus, Type 2 drug therapy
Diabetic Ketoacidosis blood
Diabetic Ketoacidosis diagnosis
Diabetic Ketoacidosis drug therapy
Diabetic Ketoacidosis etiology
Diabetic Ketoacidosis physiopathology
Glucosides administration & dosage
Glucosides adverse effects
Insulin administration & dosage
Obesity complications
Subjects
Details
- Language :
- English
- ISSN :
- 1742-7843
- Volume :
- 118
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Basic & clinical pharmacology & toxicology
- Publication Type :
- Academic Journal
- Accession number :
- 26291182
- Full Text :
- https://doi.org/10.1111/bcpt.12457