Inhibitors of sodium-glucose cotransporter 2: risk of ketoacidosis

SGLT2 inhibitors form a new class of hypoglycemic drugs. Despite of the pharmacodynamic profile, at the moment the opinion about their safety is controversial. This is due to increased number of reports given by FDA and EMA on the risk of serious adverse reactions - ketoacidosis, which is not specified in the instruction as a possible adverse effects. Ketatsidosis in patients with type 2 diabetes on therapy with SGLT2 inhibitors was appeared at moderately elevated glucose levels (200 mg/dL/11.1 mmol/L). The article deals with reports of ketoacidosis, caused by inhibition of SGLT2 and describes the alleged internal pathophysiological mechanisms associated with its development.