Intensive Care Unit, Royal Surrey County Hospital NHS Foundation Trust, Egerton Road, Guildford, Surrey GU2 7XX, UK.
Cedar Centre, Department of Endocrinology & Diabetes, Royal Surrey County Hospital NHS Foundation Trust, Egerton Road, Guildford, Surrey GU2 7XX, UK.
J Crit Care. 2020 Jun;57:19-22. doi: 10.1016/j.jcrc.2019.12.007. Epub 2019 Dec 10.
Sodium glucose cotransporter 2 (SGLT2) inhibitors are the latest class of oral hypoglycaemic agents approved to treat type II diabetes. Their use is increasing and as such more patients will present to critical care whilst on this treatment. However, there have been several case reports of euglycaemic diabetic ketoacidosis associated with the use of these agents. Under such circumstances the blood glucose is often normal or only moderately elevated and hence the diagnosis may be delayed resulting in inappropriate therapy. In this review we describe a case of SGLT2 mediated ketoacidosis who presented to our intensive care unit, discuss the proposed pathophysiology behind this development of ketoacidosis as well as its potential prevention, management and treatment.
钠-葡萄糖共转运蛋白 2（SGLT2）抑制剂是最近批准用于治疗 2 型糖尿病的一类口服降糖药。随着其应用的增加，更多的患者在接受这种治疗时会到重症监护病房就诊。然而，已经有几例报道称，使用这些药物会导致血糖正常或仅中度升高的糖尿病酮症酸中毒。因此，诊断可能会延迟，导致治疗不当。在这篇综述中，我们描述了一例 SGLT2 介导的酮症酸中毒患者在我们的重症监护病房就诊的情况，讨论了这种酮症酸中毒发展的病理生理学机制，以及其潜在的预防、管理和治疗方法。
