虽然英国(NICE)批准在T1DM人群中使用SGLT-2i:但是这种药物在使用的时候会造成1型糖尿病患者euDKA。 euDKA——正糖血糖的糖尿病酮症酸中毒 euDKA正常血糖型糖尿病酮症酸中毒(Euglycemic Diabetic Ketoacidosis),eu-DKA是DKA中一种特殊的类型,临床表现为:合并酮血症和酸血症,但体内的降糖因素使患者不合并高血糖。 例...
综上所述,SGLT-2i可通过多种途径使酮体生成增加、清除率下降,导致酮体蓄积而引发酮症酸中毒,由于SGLT-2i可增加尿糖排泄,患者在发生酮症酸中毒时,血糖往往不超过13.9mmoL/L,被称为“血糖不高的DKA”,容易被忽视或漏诊。建议在使用SGLT-2i期间,若患者出现如恶心...
Introduction: The SGLT-2 inhibitors (SGLT-2i) are a newer anti-diabetic drugs. Their use has tremendously increased due to their favorable profile but they are also the focus of attention because of their side effect of euglycemic diabetic ketoacidosis (euDKA), which is challenging to diagnose...
随着SGLT-2i的广泛使用,临床医师需对SGLT-2i的使用人群进行密切关注与用药教育。 注解: ①正常血糖性糖尿病酮症酸中毒:euglycemic diabetic ke- to acidosis, euDKA ②钠-葡萄糖共转运蛋白- 2:sodium-dependentglucose transporter 2, SGL...
血糖正常的糖尿病酮症酸中毒(Euglycemic Diabetic Ketoacidosis,EDKA)定义为血糖<11.1mmol/L、存在代谢性酸中毒、阴离子间隙增加且存在尿酮或血酮阳性。因绝大多数所谓的“血糖正常的 DKA”,其血糖水平在所定义的阈值之上,故亦称为“低于预期血糖水平的DKA”。此类患者DKA症状常不典型,往往不易被诊断。在 FDA不良事件...
SGLT2i可能会引起血酮升高,轻度血酮升高是SGLT2i可能的心肾保护机制之一,但需关注DKA发生风险。值得注意的是,SGLT2i治疗中发生的DKA约70%为血糖正常型酮症酸中毒(euglycemic diabetic ketoacidosis,euDKA)。SGLT2i增加尿糖排泄降低血糖,胰岛素分泌减少和胰高血糖素分泌增加;特别是在并发疾病和(或)代谢应激(如手术、...
SGLT2 inhibitors are a new class of drug for the treatment of type 2 diabetes, but they are also being used off label in patients with type 1 diabetes. SUGGESTED for you One of the most concerning aspects of this euglycemic DKA is that patients do not realize it is happening: because gl...
Euglycemic diabetic ketoacidosis (EuDKA) secondary to Sodium-glucose co-transporter-2 inhibitors (SGLT2i) in type 2 diabetes mellitus (T2D) is a rare but increasingly reported phenomenon. Not much is known about the burden of EuDKA in patients on SGLT2i or the associated factors. This retrosp...
Sodium-glucose co-transporter-2 (SGLT2) inhibitors, integral in type 2 diabetes mellitus (T2DM) management, are not without risks, with reported adverse effects including euglycemic diabetic ketoacidosis (EDKA). We present a case of a 75-year-old female with T2DM on canagliflozin, who developed...
SGLT2 inhibitors have been associated with an increased risk of euglycemic diabetic ketoacidosis (DKA).71,72 An observational study of patients in the United States identified several risk factors for hospitalization owing to SGLT2 inhibitor-associated DKA, including use of digoxin or medication for ...