Abstract
Diabetes mellitus is increasingly diagnosed today. In the treatment of diabetes mellitus, insulin and many oral anti-diabetic agents are used. With the increasing understanding of the pathophysiology of diabetes mellitus today, new pharmacological drugs are being developed and marketed for the use of patients in the treatment of diabetes. SGLT2 inhibitors from top-grade antidiabetic agents were used in the last decade for the use of patients diagnosed with diabetes and one of the newer generation drugs with different mechanisms of action. However, studies and case-reports suggesting that this drug group may increase the risk of euglycemic diabetic ketoacidosis. F.D.A (Food and Drug Administration) a warning was issued by May 2015. In this article we aimed to investigate the relationship between SGLT-2 inhibitors and diabetic ketoacidosis and to show that further data collection and study in this regard and appropriate follow-up are warranted.
Highlights
SGLT-2 inhibitors are a new class of drugs that lower blood sugar by inhibiting sodium-glucose cotransporter 2 in the treatment of type 2 diabetes
Diabetic ketoacidosis (DKA) tends to occur in poorly controlled type 1 diabetes patients with severe insulin insufficiency, but may be seen in patients with Type 2 diabetes who are suffering from exogenous stress infection, trauma, or post-surgical disease
Eleven cases of diabetic ketoacidosis have been reported with slight or normal blood glucose level when using the SGLT-2 inhibitor Canagliflozin.Of these 9 patients, 7 were Type 1 diabetes mellitus patients who had been treated with diabetic ketoacidosis, which was 11 times
Summary
SGLT-2 inhibitors are a new class of drugs that lower blood sugar by inhibiting sodium-glucose cotransporter 2 in the treatment of type 2 diabetes. The HBA1C reduction effects of these agents are approximately 0.5-1.0% [1,2] These drugs inhibit SGLT-2 in the proximal nephron and these effects increase glucose excretion from urine up to 80g/day by reducing endogenous glucose reabsorbtion [2,3]. Since this is insulin-dependent, SGLT2 inhibitors can be used in any type 2 diabetes mellitus, including patients in whom insulin secretion has been significantly reduced. Eleven cases of diabetic ketoacidosis have been reported with slight or normal blood glucose level when using the SGLT-2 inhibitor Canagliflozin.Of these 9 patients, 7 were Type 1 diabetes mellitus patients who had been treated with diabetic ketoacidosis, which was 11 times. One of these two cases of euglycemic diabetic ketoacidosis was diagnosed as mucinous cystadenocarcinoma and distal pancreatomy was performed.This patient was being treated
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