Hayami Tomohide, Kato Yoshiro, Kamiya Hideki, Kondo Masaki, Naito Ena, Sugiura Yukako, Kojima Chika, Sato Sami, Yamada Yuichiro, Kasagi Rina, Ando Toshihito, Noda Saeko, Nakai Hiromi, Takada Eriko, Asano Emi, Motegi Mikio, Watarai Atsuko, Kato Koichi, Nakamura Jiro
Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine Nagakute, Japan.
Center for Preventive Medicine, Chubu Rosai Hospital Nagoya, Aichi, Japan.
J Diabetes Investig. 2015 Sep;6(5):587-90. doi: 10.1111/jdi.12330. Epub 2015 Feb 20.
We present a case of a 32-year-old diabetic woman with Prader-Willi syndrome who developed severe ketoacidosis caused by a sodium-glucose cotransporter 2 (SGLT2) inhibitor, a novel class of antihyperglycemic agents, during a strict low-carbohydrate diet. At admission, a serum glucose level of 191 mg/dL was relatively low, though laboratory evaluations showed severe ketoacidosis. This is the first report of ketoacidosis caused by a SGLT2 inhibitor. It is necessary to not only pay attention when using a SGLT2 inhibitor in patients following a low-carbohydrate diet, but also to start a low-carbohydrate diet in patients treated with a SGLT2 inhibitor because of a high risk for developing ketoacidosis.
我们报告一例32岁患有普拉德-威利综合征的糖尿病女性病例，该患者在严格的低碳水化合物饮食期间，因新型抗高血糖药物钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂而发生严重酮症酸中毒。入院时，血清葡萄糖水平为191mg/dL相对较低，尽管实验室检查显示存在严重酮症酸中毒。这是关于SGLT2抑制剂引起酮症酸中毒的首例报告。不仅在低碳水化合物饮食的患者中使用SGLT2抑制剂时需要注意，而且由于发生酮症酸中毒的风险较高，在接受SGLT2抑制剂治疗的患者中开始低碳水化合物饮食时也有必要加以注意。
