Taniguchi Hiroaki, Terayama Takero, Seno Soichiro, Kiriu Nobuaki, Kato Hiroshi, Sekine Yasumasa, Kiyozumi Tetsuro
Department of Traumatology and Critical Care Medicine, National Defense Medical College Hospital, Tokorozawa City, Saitama, Japan.
Oxf Med Case Reports. 2023 Jul 18;2023(7):omad074. doi: 10.1093/omcr/omad074. eCollection 2023 Jul.
Sodium-glucose cotransporter 2 (SGLT2) inhibitors are used to treat patients with type 2 diabetes mellitus but may induce diabetic ketoacidosis (DKA). Owing to their pharmacological mechanisms, they cause a different pathogenesis to that of typical DKA and require special attention in terms of blood glucose concentrations and acidosis. We describe a case of prolonged acidosis because of failure to immediately discover the use of an SGLT2 inhibitor. Compared with typical DKA, SGLT2 inhibitor-associated DKA requires earlier and longer glucose supplementation. SGLT2 inhibitors are specific aetiological factors in DKA, and their use should be suspected when the patient presents with mild hyperglycaemia or prolonged acidosis.
钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂用于治疗2型糖尿病患者，但可能诱发糖尿病酮症酸中毒（DKA）。由于其药理机制，它们导致的发病机制与典型DKA不同，在血糖浓度和酸中毒方面需要特别关注。我们描述了一例因未立即发现使用SGLT2抑制剂而导致的长时间酸中毒病例。与典型DKA相比，SGLT2抑制剂相关的DKA需要更早、更长时间地补充葡萄糖。SGLT2抑制剂是DKA的特定病因，当患者出现轻度高血糖或长时间酸中毒时，应怀疑使用了该类药物。
