Department of Cardiology, Fiona Stanley Hospital, Perth, Western Australia, Australia.
Department of General Medicine and Endocrinology, Fremantle Hospital, Perth, Western Australia, Australia.
Intern Med J. 2022 May;52(5):876-879. doi: 10.1111/imj.15772.
Sodium-glucose co-transporter 2 inhibitors (SGLT2i) improve cardiovascular outcomes in patients with type 2 diabetes (T2D). Diabetic ketoacidosis (DKA) is an uncommon, but well recognised, life-threatening complication of SGLT2i. In a retrospective study of patients with T2D undergoing cardiac surgery at our institution, DKA occurred in 15.3% of patients taking SGLT2i at the time of surgery, compared with 0.47% of non-SGLT2i-treated patients. Intravenous insulin in the first 24 h after surgery was associated with a significantly lower risk of DKA in SGLT2i patients. Use of an insulin infusion should be considered in these patients, especially in those who are unable to cease their SGLT2i pre-operatively.
钠-葡萄糖共转运蛋白 2 抑制剂（SGLT2i）可改善 2 型糖尿病（T2D）患者的心血管结局。糖尿病酮症酸中毒（DKA）是 SGLT2i 一种罕见但严重的危及生命的并发症。在对我院接受心脏手术的 T2D 患者进行的回顾性研究中，在手术时服用 SGLT2i 的患者中，DKA 的发生率为 15.3%，而非 SGLT2i 治疗的患者中为 0.47%。术后 24 小时内使用静脉胰岛素与 SGLT2i 患者的 DKA 风险显著降低相关。应考虑在这些患者中使用胰岛素输注，特别是那些术前无法停止 SGLT2i 的患者。
