Sodium-glucose co-transporter-2 inhibitors and diabetic ketoacidosis: An updated review of the literature

Diabetes, Obesity & Metabolism
Benedetta Maria BonoraGian Paolo Fadini

Abstract

Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are increasingly used for the treatment of type 2 diabetes (T2D) and can improve glucose control also in type 1 diabetes (T1D). In May 2015, regulatory agencies issued a warning that SGLT2is may cause diabetic ketoacidosis (DKA). We report details on 2 new cases of SGLT2i-associated DKA and review the literature for similar cases within randomized controlled trials (RCTs), cohort studies and single reports. We searched the medical literature for reports of SGLT2i-associated DKA cases. A quantitative analysis of frequency and clinical characteristics is reported. The 2 narrative cases illustrate that SGLT2i-associated DKA can occur in patients with T1D incorrectly diagnosed as T2D, perhaps without the presence of obvious DKA precipitating factors. The incidence of SGLT2i-associated DKA was less than 1/1000 in randomized controlled trials and 1.6/1000 person-years in cohort studies. We retrieved detailed data on 105 SGLT2i-associated DKA case reports, wherein 35% showed glucose levels of less than 200 mg/dL and 22% were not associated with typical triggers. In case reports and in pharmacovigilance databases, duration of SGLT2i treatment before DKA onset was extremely variable. F...Continue Reading

References

Feb 1, 1996·Journal of Endocrinological Investigation·A AvogaroS Del Prato
May 25, 2011·Endocrine Reviews·Muhammad A Abdul-GhaniRalph A Defronzo
Sep 20, 2012·Cardiology in Review·Paula S AzevedoLeonardo A M Zornoff
Jan 28, 2014·The Journal of Clinical Investigation·Ele FerranniniHans-Juergen Woerle
Sep 7, 2014·Canadian Journal of Diabetes·David Z I Cherney, Bruce A Perkins
Nov 30, 2014·The American Journal of Emergency Medicine·Reginald St Hilaire, Heather Costello
May 31, 2015·The Lancet. Diabetes & Endocrinology·Julia HineRoselle Herring
Jul 21, 2015·Endocrinology, Diabetes & Metabolism Case Reports·Arshpreet Kaur, Stephen J Winters
Aug 1, 2015·Journal of Basic and Clinical Pharmacy·Narat SrivaliPatompong Ungprasert
Aug 21, 2015·Basic & Clinical Pharmacology & Toxicology·Heidi StorgaardJørgen Rungby
Sep 18, 2015·The New England Journal of Medicine·Bernard ZinmanUNKNOWN EMPA-REG OUTCOME Investigators
Dec 22, 2015·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Fernando B BonanniLaura L Fitzpatrick
Dec 23, 2015·Indian Journal of Endocrinology and Metabolism·Awadhesh Kumar Singh
Feb 20, 2016·Nature Reviews. Endocrinology·Guillermo Umpierrez, Mary Korytkowski
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 12, 2016·Diabetes Care·Ele FerranniniEric Mayoux
Jun 29, 2016·Diabetes Research and Clinical Practice·Spyridoula MarakaDerek T O'Keeffe
Jul 9, 2016·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·Jean-Luc Faillie
Jul 21, 2016·Diabetes Care·Peter D FarjoJosephine L Reece
Jul 30, 2016·Oxford Medical Case Reports·Nellowe Candelario, Jedrzej Wykretowicz
Aug 5, 2016·The Journal of Clinical Endocrinology and Metabolism·Nitesh D KuhadiyaParesh Dandona
Sep 17, 2016·Journal of Investigative Medicine High Impact Case Reports·Jessica TurnerRoger D Smalligan
Oct 5, 2016·Annals of Internal Medicine·Shane A BobartSandra F Williams
Dec 4, 2016·Journal of Diabetes and Its Complications·Juliette Sandifer Kum-NjiSamuel Dagogo-Jack
Jan 17, 2017·Internal Medicine·Junichiro AdachiChisato Maki
Mar 23, 2017·The Journal of Clinical Endocrinology and Metabolism·Marino QuarellaStefan Bilz

❮ Previous
Next ❯

Citations

Jul 14, 2018·Diabetes, Obesity & Metabolism·Emanuel RaschiFabrizio De Ponti
May 14, 2019·Diabetes, Obesity & Metabolism·Jessica A Dominguez Rieg, Timo Rieg
Sep 19, 2019·Clinical Medicine : Journal of the Royal College of Physicians of London·Kate Evans
Aug 11, 2020·Current Medical Research and Opinion·Chutintorn SriphrapradangThep Himathongkam
May 26, 2018·Current Opinion in Endocrinology, Diabetes, and Obesity·Halis Kaan AkturkSatish K Garg
Apr 14, 2019·Wiener klinische Wochenschrift·Peter FaschingBernhard Ludvik
Feb 1, 2020·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Jose Luis GórrizMaria Jose Soler
Aug 21, 2019·International Journal of Environmental Research and Public Health·Anastasios TentolourisNikolaos Tentolouris
Jun 15, 2019·Case Reports in Endocrinology·Eleni Papadokostaki, Evangelos Liberopoulos
Apr 9, 2020·Emergency Medicine Australasia : EMA·Adam Morton
Jul 18, 2018·Clinical Medicine Insights. Endocrinology and Diabetes·Jennifer D Goldman
May 20, 2020·Current Diabetes Reports·Benedetta Maria BonoraGian Paolo Fadini
Mar 7, 2020·Journal of the American Geriatrics Society·Dan SchwarzfuchsLeonid Barski
Oct 24, 2020·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Tamara Y MilderJerry R Greenfield
Mar 22, 2020·Diabetes Research and Clinical Practice·Angela DardanoStefano Del Prato
Feb 11, 2021·Clinical Journal of the American Society of Nephrology : CJASN·Biff F Palmer, Deborah J Clegg
May 18, 2021·World Journal of Diabetes·Prashant NasaAanchal Singh
Jul 11, 2020·Reviews on Recent Clinical Trials·Dario PitoccoAlfredo Pontecorvi
Oct 17, 2021·Emergency Medicine Australasia : EMA·Adam Morton

❮ Previous
Next ❯

Related Concepts

Related Feeds

Autoimmune Diabetes & Tolerance

Patients with type I diabetes lack insulin-producing beta cells due to the loss of immunological tolerance and autoimmune disease. Discover the latest research on targeting tolerance to prevent diabetes.