Diabetic ketoacidosis in patients treated with SGLT2 inhibitors: experience at a tertiary hospital

HORMONES ◽  
2020 ◽  
Author(s):  
Labrini Papanastasiou ◽  
Spyridoula Glycofridi ◽  
Christos Gravvanis ◽  
Nikitas Skarakis ◽  
Irene Papadimitriou ◽  
...  
Keyword(s):  
Diabetic Ketoacidosis ◽  
Tertiary Hospital ◽  
Sglt2 Inhibitors

Safety of SGLT2 Inhibitors in Patients with Diabetes Mellitus

2019 ◽  
Vol 14 (2) ◽  
pp. 87-93 ◽  
Author(s):  
Mahakpreet Singh ◽  
Ruchika Sharma ◽  
Anoop Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Diabetic Ketoacidosis ◽  
Adverse Drug Reactions ◽  
Sglt2 Inhibitor ◽  
Sglt2 Inhibitors ◽  
Drug Reactions ◽  
Authorization Holder

Background:Recently, Food and Drug Administration (FDA) has approved sodium/ glucose co-transporter 2 (SGLT2) inhibitors for the treatment of diabetes mellitus. However, regarding adverse drug reactions (ADRs) of SGLT2 inhibitors in large group of population, very less information is available. Thus, we have tried to find out the risk profile of SGLT2 inhibitors. Materials and Methods: A total of 1,042 studies have been published from Nov. 2012-Nov. 2017 regarding SGLT2 inhibitors. After inclusion and exclusion criteria, 27 studies have been selected for the analysis of risk. Results and Discussion:The emerging evidence indicates various adverse drug reactions such as foot and toe amputation, cancer, diabetic ketoacidosis, bone fracture risk and urinary as well as mycotic genital infection. The causality assessment has shown a correlation between SGLT2 inhibitors and diabetic ketoacidosis and urinary tract infection. Conclusion:In conclusion, Marketing Authorization Holder (MAH) and Regulatory Authorities (RA) should monitor various adverse drug reactions such as diabetic ketoacidosis and urinary tract infection with the use of SGLT2 inhibitor.

Gaps in Diabetic Ketoacidosis Management at a Tertiary Hospital: Need for Quality Improvement

2017 ◽  
Vol 41 (5) ◽  
pp. S53
Author(s):  
Angela Assal ◽  
Bikrampal Sidhu ◽  
Christine Ibrahim ◽  
Vithika Sivabalasundaram ◽  
Ilana Halperin ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Diabetic Ketoacidosis ◽  
Tertiary Hospital

scholarly journals SGLT2 inhibitors and the risk of diabetic ketoacidosis among adults with Type 2 Diabetes: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Michael Colacci ◽  
John Fralick ◽  
Ayodele Odutayo ◽  
Michael Fralick
Keyword(s):  
Diabetic Ketoacidosis ◽  
Observational Studies ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Sglt2 Inhibitor ◽  
Sglt2 Inhibitors ◽  
Controlled Trials ◽  
Absolute Rate ◽  
Randomized Controlled

Importance: The risk of diabetic ketoacidosis (DKA) with sodium-glucose cotransporter-2 (SGLT2) inhibitors is unclear. Objective: To examine the risk of DKA with SGLT2 inhibitors in both observational studies and large clinical trials. Data Sources: Searches of PubMed, EMBASE and CENTRAL (inception to 15 April 2019) without language restrictions; conference proceedings; and reference lists. Study Selection: Randomized controlled trials and observational studies that quantified the rate of diabetic ketoacidosis with an SGLT2 inhibitor in comparison to another diabetes medication or placebo. Data Extraction and Synthesis: Two independent investigators abstracted study data and assessed the quality of evidence. Data were pooled using random effects models with the Hartung-Knapp-Sidik-Jonkman method. Main Outcome and Measures: Absolute event rates and hazard ratios for diabetic ketoacidosis were extracted from each study. Results: Seven randomized trials encompassing 42,375 participants and five cohort studies encompassing 318,636 participants were selected. Among the 7 randomized controlled trials, the absolute rate of DKA among patients randomized to an SGLT2 inhibitor ranged from 0.6 to 2.2 events per 1000 person years. Four randomized trials were included in the meta-analysis, and compared to placebo or comparator medication, SGLT2 inhibitors had a 2.4-fold higher risk of DKA (Relative Risk [RR] = 2.46 [95% CI, 1.16-5.21]; I2 = 0%; P = 0.54). Among the 5 observational studies, the absolute rate of DKA associated with SGLT2 inhibitor use ranged from 0.6 to 4.9 per 1000 person years and a 1.7-fold higher rate of DKA compared to another diabetes medication (RR = 1.74 [95% CI, 1.01-2.93]; I2 = 45%; P = 0.12). Conclusions and Relevance: In adults with type 2 diabetes, SGLT2 inhibitors increase the risk of DKA in both observational studies and large randomized clinical trials. Registration: CRD42019146855 Funding Source: None

scholarly journals Euglycemic Diabetic Ketoacidosis in a Lung Cancer Patient Using Empagliflozin

2020 ◽  
Vol 2020 ◽  
pp. 1-3 ◽  
Author(s):  
Jordan Sexe ◽  
Chadwick Mayes ◽  
Peter Tofts
Keyword(s):  
Lung Cancer ◽  
Emergency Department ◽  
Diabetic Ketoacidosis ◽  
Lung Cancer Patient ◽  
Renal Excretion ◽  
Delayed Diagnosis ◽  
Sglt2 Inhibitors ◽  
Diabetic Patients ◽  
New Class ◽  
Euglycemic Diabetic Ketoacidosis

Diabetic ketoacidosis is a leading cause of morbidity and mortality in diabetic patients, and its diagnosis should be timely and accurate. SGLT2 inhibitors are a new class of antidiabetic medications that increase the renal excretion of glucose. It is thought that increased urinary excretion of glucose will mask hyperglycemia during DKA. This can lead to a delayed diagnosis of DKA and worsen outcomes. In this report, we detail a case of euglycemic DKA in a patient who presented to the Emergency Department meeting criteria for septic shock.

scholarly journals 081 Assessment of SGLT2 Inhibitors use in Heart Failure Patients at a Tertiary Hospital

2020 ◽  
Vol 29 ◽  
pp. S73-S74
Author(s):  
D. Gohel ◽  
A. Munsif ◽  
V. Paul ◽  
A. Joseph ◽  
E. Hibbert ◽  
...  
Keyword(s):  
Heart Failure ◽  
Tertiary Hospital ◽  
Sglt2 Inhibitors ◽  
Heart Failure Patients
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