Miyauchi Masaaki, Toyoda Masao, Fukagawa Masafumi
Division of Endocrinology and Diabetes, Department of Internal Medicine, Isehara Kyodo Hospital, Japan.
Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Japan.
Intern Med. 2017;56(13):1673-1678. doi: 10.2169/internalmedicine.56.7945. Epub 2017 Jul 1.
We herein present the case of a 21-year-old diabetic obese woman who developed ketoacidosis following the administration of ipragliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor. At the time of admission, although her serum glucose level was only 175 mg/dL, laboratory tests showed ketoacidosis. Interestingly, hyperglycosuria persisted, even after the discontinuation of ipragliflozin. This is the first report of non-hyperglycemic ketoacidosis that might have been caused by protracted hyperglycosuria after the discontinuation of ipragliflozin. The development of non-hyperglycemic ketoacidosis should be monitored following the discontinuation of SGLT2 inhibitors, especially in patients who start to feel unwell and exhibit protracted hyperglycosuria after the discontinuation of treatment.
我们在此报告一例21岁的糖尿病肥胖女性病例，该患者在使用钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂依帕列净后发生了酮症酸中毒。入院时，尽管她的血清葡萄糖水平仅为175mg/dL，但实验室检查显示存在酮症酸中毒。有趣的是，即使在停用依帕列净后，高糖尿症仍持续存在。这是首例关于停用依帕列净后可能因持续性高糖尿症导致的非高血糖性酮症酸中毒的报告。停用SGLT2抑制剂后，应监测非高血糖性酮症酸中毒的发生，尤其是在停药后开始感觉不适并出现持续性高糖尿症的患者中。
