Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/20440
Title: SGLT2 Inhibitors Increase the Risk of Diabetic Ketoacidosis Developing in the Community and During Hospital Admission.
Austin Authors: Hamblin, Peter S;Wong, Rosemary;Ekinci, Elif I ;Fourlanos, Spiros;Shah, Sonali;Jones, Alicia R;Hare, Matthew J L;Calder, Genevieve L;Epa, Dilan Seneviratne;George, Elizabeth M;Giri, Rinky;Kotowicz, Mark A;Kyi, Mervyn;Lafontaine, Nicole;MacIsaac, Richard J;Nolan, Brendan James ;O'Neal, David N;Renouf, Debra;Varadarajan, Suresh;Wong, Jennifer;Xu, Sylvia;Bach, Leon A
Affiliation: Department of Medicine, Monash University
Department of Medicine-Western Precinct, The University of Melbourne
Department of Endocrinology & Diabetes, Eastern Health, Box Hill, Victoria, Australia
Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Diabetes & Endocrinology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
Department of Medicine - Royal Melbourne Hospital, The University of Melbourne
Department of Endocrinology & Diabetes, Monash Health, Clayton, Victoria, Australia
Department of Endocrinology & Diabetes, Alfred Health, Melbourne, Victoria, Australia
Department of Diabetes & Endocrinology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
Department of Endocrinology & Diabetes, University Hospital Geelong, Barwon Health, Victoria, Australia
Werribee Mercy Hospital, Princess Highway Werribee, Victoria, Australia
Diabetes Technology Research Group, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
School of Medicine, Faculty of Health, Deakin University, Geelong, Victoria, Australia
Department of Medicine - St Vincent's Hospital Melbourne, The University of Melbourne
Department of Endocrinology & Diabetes, Northern Health, Epping, Victoria, Australia
Department of Endocrinology & Diabetes, Peninsula Health Frankston, Victoria, Australia
Peninsula Clinical School, Monash University
Department of Medicine, Central Clinical School, Monash University
Department of Endocrinology & Diabetes, Western Health, St Albans, Victoria, Australia
Issue Date: 1-Aug-2019
metadata.dc.date: 2019-03-05
Publication information: The Journal of Clinical Endocrinology and Metabolism 2019; 104(8): 3077-3087
Abstract: Diabetic ketoacidosis (DKA) has been associated with the use of sodium glucose cotransporter 2 inhibitors (SGLT2i). To determine the incidence, characteristics and outcomes of DKA in SGLT2i-users vs non-users with type 2 diabetes. Retrospective, multi-center, controlled cohort study. All public hospitals in Melbourne and Geelong (combined population 5 million), Australia, from 1 September 2015 - 31 October 2017. Consecutive cases of DKA that developed in the community, or during the course of hospital admission, in patients with type 2 diabetes. In SGLT2i users vs non-users: (i) Odds ratio of DKA developing during hospital admission and (ii) Incidence of DKA. There were 162 cases of DKA (37 SGLT2i users and 125 non-SGLT2i users) with a physician-adjudicated diagnosis of type 2 diabetes. Of these, DKA developed during the course of inpatient admission in 14 (38%) SGLT2i users vs two (2%) non-SGLT2i users, (odds ratio 37.4 [95% CI 8.0-175.9], p<0.0001). The incidence of diabetic ketoacidosis was 1.02/1000 (95% CI 0.74-1.41/1000) in SGLT2i users vs 0.69/1000 (0.58-0.82/1000) in non-SGLT2i users (odds ratio 1.48 (1.02-2.15), p=0.037). Fifteen SGLT2i users (41%) had peak blood glucose <250 mg/dl (14 mmol/l) compared to one (0.8%) non-SGLT2i user (p<0.001). SGLT2i users were more likely to develop DKA as an inpatient compared to non-SGLT2i users. SGLT2i use was associated with a small, but significant increased risk of DKA.
URI: http://ahro.austin.org.au/austinjspui/handle/1/20440
DOI: 10.1210/jc.2019-00139
ORCID: 0000-0003-2372-395X
PubMed URL: 30835263
Type: Journal Article
Appears in Collections:Journal articles

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