Diabetes & Metabolism Journal

Chaiho Jeong

1 Article

Complications
Diabetic Ketoacidosis as an Effect of Sodium-Glucose Cotransporter 2 Inhibitor: Real World Insights: Han-Sang Baek, Chaiho Jeong, Yeoree Yang, Joonyub Lee, Jeongmin Lee, Seung-Hwan Lee, Jae Hyoung Cho, Tae-Seo Sohn, Hyun-Shik Son, Kun-Ho Yoon, Eun Young Lee; Diabetes Metab J. 2024;48(6):1169-1175. Published online June 10, 2024; DOI: https://doi.org/10.4093/dmj.2024.0036

7,318 View
336 Download
5 Web of Science
6 Crossref

One of the notable adverse effects of sodium-glucose cotransporter 2 (SGLT2) inhibitor is diabetic ketoacidosis (DKA) often characterized by euglycemia. In this retrospective review of patients with DKA from 2015 to 2023, 21 cases of SGLT2 inhibitorassociated DKA were identified. Twelve (57.1%) exhibited euglycemic DKA (euDKA) while nine (42.9%) had hyperglycemic DKA (hyDKA). More than 90% of these cases were patients with type 2 diabetes mellitus. Despite similar age, sex, body mass index, and diabetes duration, individuals with hyDKA showed poorer glycemic control and lower C-peptide levels compared with euDKA. Renal impairment and acidosis were worse in the hyDKA group, requiring hemodialysis in two patients. Approximately one-half of hyDKA patients had concurrent hyperosmolar hyperglycemic state. Common symptoms included nausea, vomiting, general weakness, and dyspnea. Seizure was the initial manifestation of DKA in two cases. Infection and volume depletion were major contributors, while carbohydrate restriction and inadequate insulin treatment also contributed to SGLT2 inhibitor-associated DKA. Despite their beneficial effects, clinicians should be vigilant for SGLT2 inhibitor risk associated with DKA.

Citations

Citations to this article as recorded by

Dapagliflozin/Empagliflozin/Ertugliflozin

Reactions Weekly.2025; 2042(1): 142. CrossRef
Diabetes Mellitus at an Elderly Age
Andrej Zeyfang, Jürgen Wernecke, Anke Bahrmann
Experimental and Clinical Endocrinology & Diabetes.2025; 133(04): 168. CrossRef
SGLT2 Inhibitors and GLP-1 Receptor Agonists in Diabetic Kidney Disease: Evolving Evidence and Clinical Application
Jae Hyun Bae
Diabetes & Metabolism Journal.2025; 49(3): 386. CrossRef
Diabetes mellitus im Alter
Andrej Zeyfang, Jürgen Wernecke, Anke Bahrmann
Die Diabetologie.2025; 21(4): 503. CrossRef
Cardiorenal outcomes and safety of SGLT2 inhibitors in patients with diabetes secondary to disorders of the exocrine pancreas: a nationwide population-based study
Kyoung Hwa Ha, Minae Park, Yujin Lee, Dae Jung Kim, Seung Jin Han
Diabetes & Metabolism.2025; 51(5): 101668. CrossRef
Diabetes mellitus im Alter
Andrej Zeyfang, Jürgen Wernecke, Anke Bahrmann
Diabetologie und Stoffwechsel.2024; 19(S 02): S226. CrossRef

Author index