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sodium-glucose co-transporter 2 inhibitors induced euglycemic diabetic ketoacidosis within four days of initiation

World Journal of Diabetes 2022年第3期13卷 272-274页

作者： Almurtada Razok Fateen Ata Sara Mohamed Ibrahim Ahmed Dabia Hamad S H Al Mohanadi Department of Internal Medicine Hamad Medical CorporationDoha 3050Qatar Department of Endocrinology Hamad Medical CorporationDoha 3050Qatar

Euglycemic diabetic ketoacidosis(EDKA)is a well-known complication of sodium-glucose co-transporter 2 inhibitors,and many cases with variable onset following the initiation of these agents are reported before,with a median onset of approximately 2 *** letter discusses a 45-year-old lady who initially presented with ischemic stroke but developed EDKA 4 d after starting empagliflozin,a rare *** patient had severe metabolic acidosis that necessitated admission into the intensive care *** discontinuation of empagliflozin and DKA management resulted in clinical recovery.

关键词： Euglycemic diabetic ketoacidosis sodium-glucose co-transporter 2 inhibitors Type 2 diabetes mellitus Empagliflozin

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Euglycemic diabetic ketoacidosis:A rare but serious side effect of sodium-glucose co-transporter 2 inhibitors

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World Journal of Cardiology 2022年第10期14卷 561-564页

作者： Nenad Lakušić Ivana Sopek Merkaš Ana Marija Slišković Dora Cerovec Department of Cardiology Special Hospital for Medical Rehabilitation Krapinske TopliceKrapinske Toplice 49217Croatia Department of Clinical Medicine Faculty of Dental Medicine and Health OsijekOsijek 31000Croatia Department of Internal Medicine Family Medicine and History of MedicineFaculty of Medicine OsijekOsijek 31000Croatia Department of Cardiology University Hospital Centre ZagrebZagreb 10000Croatia

sodium-glucose co-transporter 2(SGLT2)inhibitors are an insulin-independent class of oral antihyperglycemic medication and from recently established therapy in chronic heart failure patients.A rare,but potentially life-threatening complication of SGLT2 inhibitor use is euglycemic diabetic *** described a case of a middle-aged male patient with type 2 diabetes who developed metabolic ketoacidosis after a few days of empagliflozin ***2 inhibitor related ketoacidosis presents with euglycemia or only modestly elevated glucose blood concentrations,which causes delayed detection and treatment of *** are multiple possible risk factors and mechanism that might contribute to the pathogenesis of *** is implied that SGLT2 inhibitor use and prescription by non-diabetologists(cardiologists,nephrologists,family physicians,etc.)will continue to grow in the *** is important to inform the general cardiac public about this rare but serious side effect of SGLT2 inhibitors.

关键词： sodium-glucose co-transporter 2 inhibitors Euglycemic diabetic ketoacidosis Chronic heart failure

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Canagliflozin,an inhibitor of sodium-glucose co-transporter 2,advances in the treatment of type 2 diabetes

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Journal of Chinese Pharmaceutical Sciences 2022年第8期31卷 569-588页

作者： Ying Fu Simo Liu Yan Ma Nannan Wu Center for Endocrine Metabolism and Immune Diseases Beijing Luhe HospitalCapital Medical UniversityBeijing 101149China Beijing Key Laboratory of Diabetes Research and Care Beijing 101149China

Canagliflozin(CANA)is a sodium-glucose co-transporter 2 *** of the important mechanisms of CANA is the inhibitory effect on the glucose uptake in the proximal tubule of the nephron,and the other mechanism can be the reduction of inflammatory cytokine expression monocytes and *** is proved by FDA for the management of type 2 *** the present work,we summarized the publication and clinical evidence of the CANA on healthy individuals and those with related metabolic diseases,such as type 1 and 2 diabetes,obesity,or cardiovascular and kidney *** drug has been reported to offer potential advantages in regulating body weight and reducing heart failure,hypoglycemia,and stroke risk in patients with type 2 *** in vitro and animal experiments also show that this drug has good effects on cancer ***,some case reports and experiments also show the side effect of CANA,such as amputation,fracture,and pancreatitis,while the mechanism is still ***,CANA has a good effect on the management of type 2 diabetes by reducing the risk of kidney failure,cardiovascular diseases,and ***,as a new drug,more clinical trials and experiments of CANA should be carried out in the future.

关键词： sodium-glucose co-transporter 2 inhibitors Canagliflozin Diabetes mellitus

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Finally, Some Reason for Hope in Proteinuric Kidney Disease

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Open Journal of Nephrology 2022年第3期12卷 241-248页

作者： Devin Teehan Christopher Tyburski Geoffrey Teehan Lankenau Medical Center Wynnewood USA

Background: After years of predictable outcomes with limited tools to combat the ravages of proteinuric chronic kidney disease (CKD) associated with or without diabetes, exciting new options are available to slow the progression of CKD. Purpose: Focusing on sodium-glucose co-transporter 2 inhibitors (SGLT2), angiotensin receptor blockers (ARB), angiotensin converting enzyme inhibitors (ACE I), and new mineralocorticoid antagonists (MRA), this review examines how these agents compliment the standard of care in an attempt to educate and stimulate broader use of these agents. Methods: Using the search terms “mineralocorticoid antagonist, sodium glucose co-transporter 2 inhibitors, proteinuria, albuminuria, and diabetic kidney disease,” five randomized controlled clinical trials were identified and then analyzed in the context of the results found from the Irbesartan Diabetic Nephropathy Trial (IDNT). Two trials using SGLT2 and 2 using MRA were reviewed. Results: In the 2 SGLT2 trials renal outcomes were reduced by 30% - 39% among patients with estimated GFR ranging from roughly 25 - 90 mL/min. In the 2 MRA trials, renal outcomes fell by 13% - 18% among patients with estimated GFR ranging from 25 - 90 mL/min. In the IDNT, renal outcomes fell by 19%. Trial duration ranged from 28 - 41 months, and in all trials, the IDNT, Ace inhibitors (ACE I) and ARBs use was uniform. There is small overlap in the 5 trials in which both MRA and SGLT2 agents were used. conclusions: Over a wide range of renal function, both MRA and SGLT2 inhibitors demonstrate outstanding efficacy in diabetic and non-diabetic (SGLT2) proteinuric kidney disease. compared to the prior standard of care, these agents dramatically improve outcomes.

关键词： Chronic Kidney Disease sodium-glucose co-transporter 2 inhibitors Mineralocorticoid Agonists Angiotensin Receptor Blockers Angiotensin converting Enzyme inhibitors

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