伴有胰腺炎和服用恩格列净的 2 型糖尿病患者的血糖正常的糖尿病酮症酸中毒。
Euglycaemic diabetic ketoacidosis in a patient with pancreatitis and type 2 diabetes on empagliflozin.
机构信息
Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA.
Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
出版信息
BMJ Case Rep. 2022 Jun 22;15(6):e247921. doi: 10.1136/bcr-2021-247921.
Sodium glucose cotransporter-2 (SGLT2) inhibitors are glucose-lowering drugs with proven efficacy in treating type 2 diabetes mellitus, and more recently, have been shown to improve heart failure outcomes in patients without diabetes. A rare complication of SGLT2 inhibitor use is the development of euglycaemic diabetic ketoacidosis (EDKA), characterised by euglycaemia (blood glucose level <250 mg/dL), metabolic acidosis (arterial pH <7.3 and serum bicarbonate <18 mEq/L), and ketonaemia. Given patients with EDKA do not present with the typical manifestations of diabetic ketoacidosis, including marked hyperglycaemia and dehydration, the diagnosis of EDKA may be missed and initiation of treatment delayed. We present the case of a man with recent SGLT2 inhibitor use and multiple other risk factors who developed EDKA.
钠-葡萄糖共转运蛋白 2（SGLT2）抑制剂是一种降血糖药物，已被证明可有效治疗 2 型糖尿病，最近还显示可改善无糖尿病患者的心衰结局。SGLT2 抑制剂使用的罕见并发症是出现血糖正常的糖尿病酮症酸中毒（EDKA），其特征为血糖正常（血糖水平<250mg/dL）、代谢性酸中毒（动脉 pH 值<7.3 和血清碳酸氢盐<18mEq/L）和酮血症。鉴于 EDKA 患者没有出现典型的糖尿病酮症酸中毒表现，包括明显的高血糖和脱水，因此可能会漏诊 EDKA 并延迟开始治疗。我们报告了一例近期使用 SGLT2 抑制剂且存在多种其他危险因素的患者发生 EDKA 的病例。
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