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Writer's pictureMark Nguyen, PharmD, BCEMP

SGLT-2 Inhibitor Induced Euglycemic Diabetic Ketoacidosis - #PHARMFAX

Sodium glucose co-transporter 2 inhibitors (SGLT2-I) can cause a life-threatening complication called Euglycemic Diabetic Ketoacidosis.

 

Sodium glucose co-transporter 2 inhibitors (SGLT2-I) can cause a life-threatening complication called Euglycemic Diabetic Ketoacidosis. The mechanism SGLT-2 inhibitors such as Farxiga and Jardiance, or dapagliflozin and empagliflozin, inhibit urinary glucose absorption and promote glucose excretion. This class of medications is a great adjunctive therapy for T2DM, especially those with heart failure. Keep some things are your radar. In the setting of an acute response like an infection, SGL2-i can mimic starvation states with normal serum glucose levels (< 250 mg/dL). This leads to anaerobic metabolism, increasing fatty acid and ketone production.


Check for sneaky ketones in the urine and beta-hydroxybyrate if you’re suspicious.


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