Ewha Med J.  2017 Jan;40(1):55-58. 10.12771/emj.2017.40.1.55.

Euglycemic Diabetic Ketoacidosis When Reducing Insulin Dosage in Patients Taking Sodium Glucose Cotransporter 2 Inhibitor

• Yi WJ
• Kim SK
• Youn SU
• Kang N
• Lee MW
• Park SO

• KMID: 2367898
• DOI: http://doi.org/10.12771/emj.2017.40.1.55

Abstract

Sodium glucose cotransporter 2 (SGLT2) inhibitor has been recently reported of diabetic ketoacidosis due to accumulation of ketone bodies in patients with severe dehydration caused from such like diarrhea even though the patient had normal glucose level. This is a case of ketoacidosis in normal glucose level as production of ketone bodies is stimulated in liver with increased secretion of glucagon by stimulation of α cells in pancreas due to increase of lipolysis caused from reducing insulin and by SGLT2 inhibitor among patients who are under concurrent insulin and SGLT2 inhibitor. Thus, insulin dosage reduction requires caution in order to control blood glucose level on combined treatment of SGLT2 inhibitor in a patient who is administering insulin because the patient may be caused ketoacidosis in normal blood glucose level.

Keyword

Diabetic ketoacidosis; Sodium glucose cotransporter 2

MeSH Terms

Blood Glucose
Dehydration
Diabetic Ketoacidosis*
Diarrhea
Glucagon
Glucose*
Humans
Insulin*
Ketone Bodies
Ketosis
Lipolysis
Liver
Pancreas
Sodium*
Blood Glucose
Glucagon
Glucose
Insulin
Ketone Bodies
Sodium

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