Jiménez-Montero JG1*, Cerdas-Perez S2, Ruiz-Salazar F3, Yung-Li G3, Ulate-Oviedo L4, Jiménez-Navarrete M4, Calvo-Marin J4, Alvayero C5 and Palencia J6
1Department of Endocrinology, Hospital CIMA and University of Medical Sciences, Costa Rica
2Department of Endocrinology Hospital CIMA and University of Costa Rica, Costa Rica
3Department of Endocrinology, Hospital México and University of Costa Rica San José, Costa Rica
4Department of Endocrinology, San Vicente de Paul Hospital and University, Costa Rica
5232 Ave Escalón, San Salvador, El Salvador
6Francisco Marroquin University, Guatemala
Objective: To report the development of Diabetic Ketoacidos is (DKA) associated to Sodium- Glucose co-Transporter 2 (SGLT2) inhibitors in diabetic patients. Materials and Methods: Clinical presentation, laboratory information and precipitating factors in diabetic patients with DKA associated with SGLT-2 inhibitors are described. Results: In six patients with T1DM and one T2DM SGLT-2 inhibitors were added to help improve metabolic control and weight loss. Following a variable period of time with SGLT-2 inhibitors the patients presented nausea, vomiting, dehydration, moderate hyperglycemia, acidosis and ketosis. One patient had a urinary tract infection and all had marked reduction of total daily insulin replacement. DKA was of short duration and the patients did not present further complications. All the patients received IV insulin, volume replacement and required hospitalization. Conclusion: Prescribing the lowest dose of SGLT-2 inhibitors and appropriately adjustment of total daily insulin administration can minimize the risk of DKA. In case the patient becomes sick the patient and the health care team must be vigilant and monitor capillary glucose and ketone bodies levels regularly.
Diabetes ketoacidosis; Type 2 diabetes; Type 1 diabetes; SGLT2 inhibitors; Precipitating factors
Jiménez-Montero JG, Cerdas-Perez S, Ruiz-Salazar F, Yung-Li G, Ulate- Oviedo L, Jiménez-Navarrete M, et al. Diabetes Ketoacidosis Linked to Inhibitors of Sodium Glucose Co- Transporters in Diabetic Patients in Central America. Ann Clin Diabetes Endocrinol. 2020; 3(1): 1012.