Chauhan Sukhjinder, Diaz Victoria, Ogbu Ikechukwu R, Sanchez Justin Roy P, Manov Andre E, Shah Pinak
Internal Medicine, Mountainview Hospital, Las Vegas, USA.
Cardiology, Sunrise Health GME Consortium, Las Vegas, USA.
Cureus. 2024 Aug 7;16(8):e66408. doi: 10.7759/cureus.66408. eCollection 2024 Aug.
Sodium-glucose co-transporter 2 (SGLT2) inhibitors have demonstrated efficacy in slowing the progression of chronic kidney disease (CKD), managing conditions such as congestive heart failure (CHF), and reducing cardiovascular and overall mortality in patients with type 2 diabetes mellitus (T2DM). However, their use is associated with complications, including euglycemic diabetic ketoacidosis (euDKA), genital fungal infections, and urinary tract infections (UTIs). Although rare, complications like euDKA can lead to serious consequences if not promptly addressed, as illustrated by this case report of a 90-year-old man with ischemic cardiomyopathy and type 2 diabetes who developed both euDKA and a UTI while on SGLT2 inhibitor therapy. Early identification of euDKA from SGLT2 inhibitor usage prompted cessation of the SGLT2 inhibitor and administration of insulin infusion, ultimately resolving the life-threatening condition.
钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂已被证明在减缓慢性肾脏病（CKD）进展、治疗充血性心力衰竭（CHF）等病症以及降低2型糖尿病（T2DM）患者的心血管疾病及全因死亡率方面具有疗效。然而，其使用会引发并发症，包括正常血糖性糖尿病酮症酸中毒（euDKA）、生殖器真菌感染和尿路感染（UTIs）。尽管罕见，但像euDKA这样的并发症如果不及时处理可能会导致严重后果，本病例报告中的一名90岁患有缺血性心肌病和2型糖尿病的男性在接受SGLT2抑制剂治疗时同时发生了euDKA和UTI就说明了这一点。早期识别出由SGLT2抑制剂使用引发的euDKA促使停用SGLT2抑制剂并进行胰岛素输注，最终解决了这一危及生命的状况。
