Euglycaemic diabetic ketoacidosis as a complication of SGLT-2 inhibitors: epidemiology, pathophysiology, and treatment.

Expert Opinion on Drug Safety
Erasmia SampaniAikaterini Papagianni

Abstract

Sodium-glucose co-transporters 2 (SGLT-2) inhibitors are a relatively novel class of oral medications for the treatment of Type 2 Diabetes Mellitus, which lower plasma glucose by inhibiting glucose reabsorption in the proximal renal tubule. Apart from their hypoglycemic action, recent data suggest these agents have additional major cardioprotective and nephroprotective properties. This review summarizes the existing data on epidemiology, pathophysiology, and treatment of euglycaemic ketoacidosis (euDKA) as a complication of SGLT-2 inhibitor use. Although SGLT-2 inhibitors have a relatively good adverse event profile, they have been associated with the serious and potentially life-threatening metabolic complication of euDKA. Data from major outcome trials suggest that the rate of DKA is quite low. However, the rate of DKA could be generally underestimated in clinical trials due to the atypical presentation of ketoacidosis, and even more so in real-life conditions. Management of this serious metabolic complication requires a proper understanding of its pathophysiology as well as increased awareness and early recognition of the potential risk factors involved. Following this, the institution of an array of simple supportive measur...Continue Reading

References

Jan 1, 1979·Advances in Experimental Medicine and Biology·J D McGarry, D W Foster
Jun 9, 1973·British Medical Journal·J F MunroL J Duncan
Jul 28, 2007·Journal of the American Society of Nephrology : JASN·Asghar Rastegar
Jul 23, 2008·Diabetic Medicine : a Journal of the British Diabetic Association·Z H WangJ W Eriksson
Jul 1, 2009·Diabetes Care·Abbas E KitabchiJoseph N Fisher
Jan 25, 2011·Diabetic Medicine : a Journal of the British Diabetic Association·M W SavageUNKNOWN Joint British Diabetes Societies
Sep 5, 2012·Nature Reviews. Nephrology·Jeffrey A Kraut, Nicolaos E Madias
Mar 20, 2013·Molecular Aspects of Medicine·Ernest M Wright
Jun 6, 2013·The Annals of Pharmacotherapy·Bryson DuhonDarrel W Hughes
Jul 26, 2014·Diabetes, Metabolic Syndrome and Obesity : Targets and Therapy·Aidar R GosmanovErika Dillard-Cannon
Sep 19, 2014·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·George Vlotides, Peter R Mertens
Nov 26, 2014·Annual Review of Physiology·Asim Mandal, David B Mount
Jan 27, 2015·Diabetes & Vascular Disease Research : Official Journal of the International Society of Diabetes and Vascular Disease·Linda A GalloVolker Vallon
Apr 9, 2015·Clinical Kidney Journal·Jeffrey A Kraut, Ira Kurtz
Jun 19, 2015·The Journal of Clinical Endocrinology and Metabolism·Simeon I TaylorKristina I Rother
Aug 6, 2015·The New England Journal of Medicine·Biff F Palmer, Deborah J Clegg
Sep 16, 2015·Journal of Hypertension·Konstantinos P ImprialosAsterios I Karagiannis
Sep 18, 2015·The New England Journal of Medicine·Bernard ZinmanUNKNOWN EMPA-REG OUTCOME Investigators
Nov 18, 2015·Current Opinion in Nephrology and Hypertension·Aleksandra Novikov, Volker Vallon
Apr 5, 2016·Journal of Diabetes Investigation·Wataru Ogawa, Kazuhiko Sakaguchi
Apr 16, 2016·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Yehuda HandelsmanMatthew R Weir
Jun 1, 2016·Journal of Diabetes and Its Complications·Biff F PalmerMatthew R Weir
Jun 12, 2016·Diabetes Care·Ele FerranniniEric Mayoux
Jan 19, 2017·Diabetes/metabolism Research and Reviews·Hongyu QiuVolker Vallon
Apr 25, 2017·Diabetes Research and Clinical Practice·K OgurtsovaL E Makaroff
Jun 8, 2017·The New England Journal of Medicine·Michael FralickElisabetta Patorno
Jun 13, 2017·The New England Journal of Medicine·Bruce NealUNKNOWN CANVAS Program Collaborative Group
Jul 25, 2017·Diabetes/metabolism Research and Reviews·Jenny E BlauKristina I Rother
Jul 28, 2017·Expert Opinion on Drug Safety·Theodosios FilippatosGeorge Liamis
Dec 8, 2017·Diabetology & Metabolic Syndrome·Yotsapon ThewjitcharoenThep Himathongkam

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Citations

Oct 21, 2020·Diabetes & Vascular Disease Research : Official Journal of the International Society of Diabetes and Vascular Disease·Naoya OsakaSho-Ichi Yamagishi
Feb 11, 2021·Clinical Journal of the American Society of Nephrology : CJASN·Biff F Palmer, Deborah J Clegg

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