Critical Care Management of Diabetic Ketoacidosis Caused by Sodium-Glucose Co-transporter 2 Inhibitor: A Case Report
Abstract
The sodium-glucose co-transporter 2 (SGLT2) is selectively expressed in the kidney and responsible for the reabsorption of glucose from proximal renal tubules. [1] The inhibition of this mechanism leads to increased glycosuria and decreased plasma glucose levels while the patient remains relatively euglycemic. [2] SGLT2 inhibitors were approved in 2013 by the Food and Drug Administration for the treatment of Type 2 Diabetes Mellitus (T2DM). However, the drug safety warning has been published about the risk of euglycemic Diabetic Ketoacidosis related to this group of drugs in 2015. [3] We reported our first case of euglycemic diabetic ketoacidosis complicated by an acute abdomen in the setting of SGLT2 inhibitor use. A 53-year-old male patient admitted to the Emergency Department with complaints of severe abdominal pain, nausea and vomiting. Medical history included T2DM managed with oral antidiabetics (Sitagliptin Metformin HCL and Glipizide) combined with sub-cutaneous insulin therapy. A SGLT2 inhibitor (Empagliflozin) was prescribed because of the refusal of the insulin injections about two weeks ago. There was rebound ten-derness with decreasing the bowel sounds so; he was scheduled for emergency ex-plorative laparotomy. Blood biochemistry showed the following: glucose, 200 mg/dL; creatinine,1.33 mg/dL; leucocyte count, 23.000/mm 3 . Urinalysis showed the ketonuria and glucosuria. An arterial blood gas analysis showed the metabolic acidosis with ph: 7.01, pCO 2 : 24 mmHg,…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- The Role of AMPK Activation for Cardioprotection in Doxorubicin-Induced Cardiotoxicity
- Hypoglycemic medicines in the treatment of Alzheimer’s disease: Pathophysiological links between AD and glucose metabolism
- Isorhamnetin Reduces Glucose Level, Inflammation, and Oxidative Stress in High-Fat Diet/Streptozotocin Diabetic Mice Model
- Modulating Sirtuin Biology and Nicotinamide Adenine Diphosphate Metabolism in Cardiovascular Disease—From Bench to Bedside
- Characterization of the SGLT2 Interaction Network and Its Regulation by SGLT2 Inhibitors: A Bioinformatic Analysis
- Early Treatment with Empagliflozin and GABA Improves β-Cell Mass and Glucose Tolerance in Streptozotocin-Treated Mice
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.