钠-葡萄糖共转运蛋白 2 抑制剂相关的血糖正常糖尿病酮症酸中毒的术中诊断：一例报告。
Intraoperative Diagnosis of Sodium-Glucose Cotransporter 2 Inhibitor-Associated Euglycemic Diabetic Ketoacidosis: A Case Report.
机构信息
From the Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California.
出版信息
A A Pract. 2021 Jan 14;15(1):e01380. doi: 10.1213/XAA.0000000000001380.
The use of sodium-glucose cotransporter 2 (SGLT2) inhibitors is increasingly common in type 2 diabetes mellitus (DM) management. Patients taking an SGLT2 inhibitor are at risk for euglycemic diabetic ketoacidosis (EDKA). We report an intraoperative diagnosis of EDKA. The patient was found to have an arterial pH of 7.21 and serum beta-hydroxybutyrate of 88.8 mg/dL (normal: <3.0 mg/dL) with serum glucose <250 mg/dL. Acidosis resolved with insulin and glucose infusions. Perioperative specialists must recognize the potential for EDKA in patients taking SGLT2 inhibitors. Expert opinion suggests preoperative cessation for 2-3 days and intraoperative serum ketone concentration measurement for at-risk patients.
钠-葡萄糖共转运蛋白 2（SGLT2）抑制剂在 2 型糖尿病（DM）管理中的应用越来越普遍。服用 SGLT2 抑制剂的患者有发生血糖正常的糖尿病酮症酸中毒（EDKA）的风险。我们报告了一例术中诊断的 EDKA。患者的动脉 pH 值为 7.21，血清 β-羟丁酸值为 88.8mg/dL（正常值：<3.0mg/dL），血糖<250mg/dL。酸中毒通过胰岛素和葡萄糖输注得到纠正。围手术期专家必须认识到服用 SGLT2 抑制剂的患者可能发生 EDKA。专家意见建议术前停药 2-3 天，并对高危患者进行术中血清酮体浓度测量。
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