Kosin Med J.  2018 Dec;33(3):402-408. 10.7180/kmj.2018.33.3.402.

Case of hyperosmolar hyperglycemic state by a sodium-glucose cotransporter 2 inhibitor

  • 1Department of Internal Medicine, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea. dmbak@sungae.co.kr
  • 2Department of Internal Medicine, Sungae Hospital, Seoul, Korea.
  • 3Department of Internal Medicine, CHA Bundang Medical Center, CHA university, Bundang, Korea.


Inhibitors of sodium-glucose cotransporters type 2 (SGLT2) are proposed as a novel approach for the management of type 2 diabetes mellitus. SGLT2 cotransporters are responsible for reabsorption of 90 % of the glucose filtered by the kidney. The glucuretic effect resulting from SGLT2 inhibition contributes to reduce hyperglycaemia and also assists weight loss and blood pressure reduction. In this study, we presented the case of a 59-year-old male who developed hyperosmolar hyperglycemic state (HHS), possibly caused by a sodium-glucose cotransporter 2 (SGLT2) inhibitor, a novel class of antihyperglycemic agents. This case highlights that HHS can develop in patients with diabetes treated with SGLT2 inhibitors


Diabetes mellitus; Hyperosmolar hyperglycemic state; Sodium-glucose cotransporter 2 inhibitor
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