Literature case analysis of perioperative euglycemic diabetic ketoacidosis induced by sodium-glucose cotransporter 2 inhibitors
10.3760/cma.j.cn114015-20191120-00928
- VernacularTitle:钠-葡萄糖共转运蛋白2抑制剂致围术期非高血糖型酮症酸中毒文献病例分析
- Author:
Jun CAI
1
;
Wenxia CUI
;
Lei GAO
;
Xiaoting SHI
;
Fenghui PAN
;
Yun HU
Author Information
1. 南京大学医学院附属鼓楼医院药学部 210008
- Publication Type:Journal Article
- Keywords:
Sodium-glucose transporter 2 inhibitors;
Perioperative;
Diabetic ketoacidosis
- From:
Adverse Drug Reactions Journal
2020;22(9):505-510
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical characteristics of perioperative euglycemic diabetic ketoacidosis (euDKA) induced by sodium-glucose cotransporter 2 (SGLT2) inhibitors.Methods:The case reports of perioperative euDKA caused by SGLT2 inhibitors published up to June 30, 2019 were collected by searching the relevant databases and the following information of patients including demographic characteristics, types of diabetes, use of SGLT2 inhibitors, onset time and clinical manifestation of euDKA, the blood glucose and pH, serum bicarbonate and anion gap, β-hydroxybutyric acid and ketone body concentration in urine when diagnosing euDKA, predisposing factors of euDKA, as well as the treatments and outcomes were collected. The clinical characteristics of perioperative euDKA induced by SGLT2 inhibitors were analyzed descriptively.Results:A total of 27 patients (from 20 articles) were collected, including 13 males and 14 females with an age of (58±12) years; 26 patients were with type 2 diabetes mellitus and 1 with type 1 diabetes mellitus. Of them, 15 cases were treated with canagliflozin, 6 cases were treated with dapagliflozin, and 6 cases were treated with empagliflozin; the onset time of euDKA was 10 hours to 10 days after operation and within 3 days after operation in 21 cases (77.8%); 24 cases had similar symptoms as ketoacidosis and 3 cases had no obvious symptoms; the blood glucose was (9.5±2.2) mmol/L when diagnosing euDKA and the other laboratory test results were similar to those of ketoacidosis. The main factors inducing euDKA were operation and low carbohydrate diet. After the occurrence of euDKA, all patients received insulin and rehydration therapy, and then 26 cases (96.3%) got better and 1 (3.7%) died.Conclusions:The perioperative euDKA mainly occurred within 3 days after operation. The main inducing factors of euDKA were operation and low carbohydrate diet. After insulin and rehydration therapy, most patients had a good prognosis.
