采用低碳水化合物高脂肪饮食的2型糖尿病患者出现危及生命的酮症酸中毒

[Life-threatening ketoacidosis in patients with type 2 diabetes on LCHF diet].

作者信息

Bonikowska Kamila, Magnusson Peter, Sjöholm Åke

机构信息

Gavle sjukhus - Gavle, Sweden Gavle sjukhus - Gavle, Sweden.

Uppsala Universitet - Centrum för forskning och utveckling, Region Gävleborg/Gävle Uppsala, Sweden Uppsala Universitet - Centrum för forskning och utveckling, Region Gävleborg/Gävle Uppsala, Sweden.

出版信息

Lakartidningen. 2018 Jun 29;115:E4AD.

PMID:29969145

Abstract

Patients with type 2 diabetes may develop severe ketoacidosis. A low carb high fat (LCHF) diet is oftentimes used by these patients for weight loss purposes but is also ketogenic. Antidiabetic SGLT2 inhibitors may increase glucagon secretion and may predispose to ketoacidosis, which is normoglycemic and thus makes it more difficult to suspect. We present two cases of severe ketoacidosis in type 2 diabetes patients on LCHF diet, one of which was also on SGLT2 inhibitor therapy.

摘要

2型糖尿病患者可能会发生严重的酮症酸中毒。这些患者常采用低碳高脂（LCHF）饮食来减重，但这种饮食也是生酮饮食。抗糖尿病药物钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂可能会增加胰高血糖素分泌，并可能引发酮症酸中毒，这种酮症酸中毒患者血糖正常，因此更难被怀疑。我们报告两例2型糖尿病患者在采用LCHF饮食时发生严重酮症酸中毒的病例，其中一例还接受了SGLT2抑制剂治疗。