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钠-葡萄糖协同转运蛋白2介导的正常血糖性糖尿病酮症酸中毒揭示了一名被误诊为2型糖尿病患者的潜在自身免疫性糖尿病:一例病例报告

Sodium-glucose cotransporter-2-induced euglycemic diabetic ketoacidosis unmasks latent autoimmune diabetes in a patient misdiagnosed with type 2 diabetes mellitus: a case report.

作者信息

Vadasz Brian, Arazi Mattan, Shukha Yousef, Koren Ofir, Taher Riad

机构信息

The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

Internal Medicine Department E, Rambam HealthCare Campus, Ein IbrahimUmm alfahm, POD 4147, 300100, Haifa, Israel.

出版信息

J Med Case Rep. 2021 Feb 14;15(1):62. doi: 10.1186/s13256-020-02607-2.

DOI:10.1186/s13256-020-02607-2
PMID:33581735
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7882073/
Abstract

BACKGROUND

Euglycemic diabetic ketoacidosis is an uncommon but life-threatening complication associated with the use of sodium-glucose cotransporter 2 inhibitors that causes lower than expected blood glucose levels typically seen in diabetic ketoacidosis.

CASE PRESENTATION

We present a case of 64-year-old Caucasian male patient previously diagnosed with type 2 diabetes treated with a sodium-glucose cotransporter 2 inhibitor who developed severe ketoacidosis. Serum glucose levels on initial presentation were slightly above normal baseline level. The patient was revealed to have latent autoimmune diabetes in adults.

CONCLUSION

This case highlights the importance of prescribing sodium-glucose cotransporter 2 inhibitors to the correct patient population and the significance of accurately differentiating between various types of diabetes.

摘要

背景

正常血糖性糖尿病酮症酸中毒是一种与使用钠-葡萄糖协同转运蛋白2抑制剂相关的罕见但危及生命的并发症,它会导致糖尿病酮症酸中毒中通常所见的血糖水平低于预期。

病例报告

我们报告一例64岁的白种男性患者,此前被诊断为2型糖尿病,接受钠-葡萄糖协同转运蛋白2抑制剂治疗,该患者发生了严重酮症酸中毒。初次就诊时的血清葡萄糖水平略高于正常基线水平。该患者被发现患有成人隐匿性自身免疫性糖尿病。

结论

本病例强调了为正确的患者群体开具钠-葡萄糖协同转运蛋白2抑制剂的重要性,以及准确区分各种类型糖尿病的意义。

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Med Hypotheses. 2018 May;114:11-12. doi: 10.1016/j.mehy.2018.02.025. Epub 2018 Feb 24.
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A Rose by Any Other Name: Ketoacidosis Due to SGLT2 Inhibitors Reveals Latent Autoimmune Diabetes.
Am J Med. 2018 Jan;131(1):e1-e3. doi: 10.1016/j.amjmed.2017.09.014. Epub 2017 Oct 2.
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Ketoacidosis associated with SGLT2 inhibitor treatment: Analysis of FAERS data.与 SGLT2 抑制剂治疗相关的酮症酸中毒:FAERS 数据分析。
Diabetes Metab Res Rev. 2017 Nov;33(8). doi: 10.1002/dmrr.2924. Epub 2017 Sep 29.
4
Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes.卡格列净与 2 型糖尿病的心血管和肾脏事件。
N Engl J Med. 2017 Aug 17;377(7):644-657. doi: 10.1056/NEJMoa1611925. Epub 2017 Jun 12.
5
SGLT2 inhibitors and diabetic ketoacidosis: data from the FDA Adverse Event Reporting System.钠-葡萄糖协同转运蛋白2抑制剂与糖尿病酮症酸中毒:来自美国食品药品监督管理局不良事件报告系统的数据
Diabetologia. 2017 Aug;60(8):1385-1389. doi: 10.1007/s00125-017-4301-8. Epub 2017 May 12.
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