Iqbal Qasim Z, Mishiyev Danil, Zia Zeeshan, Ruggiero Raffaele A, Aftab Ghulam
Internal Medicine, Northwell Health, New York, USA.
Pulmonary Medicine, Saint Peter's University Hospital, New Brunswick, USA.
Cureus. 2020 Oct 10;12(10):e10878. doi: 10.7759/cureus.10878.
Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are antihyperglycemic drugs that are currently being recommended as second-line therapy for patients with diabetes mellitus. SGLT-2 Inhibitors function by inhibiting renal cotransporters, which reduces the reabsorption of glucose in the kidney, ultimately decreasing the concentration of glucose in the body. They have gained popularity in recent years due to their protective effects on the heart and kidneys - both organ systems that diabetes mellitus has shown to have a deleterious effect on. However, despite their growing fame, they have been found to increase the risk of euglycemic diabetic ketoacidosis (DKA). Euglycemic DKA is particularly dangerous as there is a chance that it can be missed by clinicians due to glucose levels generally being less than 200 mg/dL. There is an increasing body of literature detailing cases of euglycemic DKA after bariatric surgery. We present a brief review of the literature regarding this important side effect of SGLT-2 inhibitors seen in patients after bariatric surgery.
钠-葡萄糖协同转运蛋白2（SGLT-2）抑制剂是一类降糖药物，目前被推荐作为糖尿病患者的二线治疗药物。SGLT-2抑制剂通过抑制肾脏协同转运蛋白发挥作用，减少肾脏对葡萄糖的重吸收，最终降低体内葡萄糖浓度。近年来，由于它们对心脏和肾脏具有保护作用，因而受到广泛关注，而糖尿病已被证明会对这两个器官系统产生有害影响。然而，尽管它们越来越知名，但已发现它们会增加正常血糖性糖尿病酮症酸中毒（DKA）的风险。正常血糖性DKA尤其危险，因为临床医生有可能因血糖水平通常低于200mg/dL而漏诊。有越来越多的文献详细描述了减肥手术后发生正常血糖性DKA的病例。我们简要回顾了有关减肥手术后患者出现的SGLT-2抑制剂这一重要副作用的文献。
