Diabetic ketoacidosis (DKA) is a leading cause of mortality and morbidity in type 2 diabetic patients. Sodium-glucose co-transporter (SGLT-2) inhibitors are a new antidiabetic treatment class that increases the renal excretion of glucose. The Food and Drug Administration issued a warning in May 2015 notifying that patients using this class of anti-diabetic drugs may develop DKA. Risk factors for DKA development among patients who take SGLT-2 inhibitors include carbohydrate intake/starvation or acute illness. In the current report, we aimed to present a case of euglycemic DKA using dapagliflozin treatment.
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1. Chao EC, Henry RR. SGLT2 inhibition--a novel strategy for diabetes treatment. Nat Rev Drug Discov 2010;9(7):551–9.
2. Dhatariya KK, Umpierrez GE. Guidelines for management of diabetic ketoacidosis: time to revise? Lancet Diabetes Endocrinol 2017;5(5):321–3.
3. Yu X, Zhang S, Zhang L. Newer Perspectives of Mechanisms for Euglycemic Diabetic Ketoacidosis. Int J Endocrinol 2018;2018:7074868.
4. Fralick M, Schneeweiss S, Patorno E. Risk of Diabetic Ketoacidosis after Initiation of an SGLT2 Inhibitor. N Engl J Med 2017;376(23):2300–2.
5. Food and Drug Administration, FDA drug safety communication: FDA warns that SGLT2 inhibitors for diabetes may result in a serious condition of too much acid in the bloodNovember 2019 http://www.fda.gov/Drugs/Drug.Safety/ucm446845.htm.
6. Taylor SI, Blau JE, Rother KI. SGLT2 Inhibitors May Predispose to Ketoacidosis. J Clin Endocrinol Metab 2015;100(8):2849–52.
7. American Diabetes Association. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes-2021. Diabetes Care 2021;44(Suppl 1):S111–24.
8. Burke KR, Schumacher CA, Harpe SE. SGLT2 Inhibitors: A Systematic Review of Diabetic Ketoacidosis and Related Risk Factors in the Primary Literature. Pharmacotherapy 2017;37(2):187–94.
Çalapkulu M, Sencar ME, Öztürk Ünsal İ, Bostan H, Çakal E (March 1, 2021) A case report of euglycemic ketoacidosis due to dapagliflozin treatment. Turkish Journal of Internal Medicine 3 Supplement 1 85–86.
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