Lee Dahyeon, Seo Gayeong, Kim Yunha, Min Jea Young, Yee Jeong
School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea.
Diabetes Obes Metab. 2025 Oct;27(10):5805-5811. doi: 10.1111/dom.16635. Epub 2025 Jul 21.
Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are effective antihyperglycaemic agents; however, they also increase the risk of diabetic ketoacidosis (DKA). As the clinical evidence comparing DKA features between SGLT2i users and non-users remains limited due to the low incidence of DKA, this study aimed to compare the clinical features and outcomes of DKA in SGLT2i users and non-users by conducting a systematic review and meta-analysis.
Relevant studies were searched in PubMed, Scopus, and Web of Science in February 2025. Studies that compared the clinical features or outcomes of DKA between SGLT2i users and non-users were included. Pooled estimates were derived using odds ratios for binary variables and mean differences for continuous variables.
A total of 9 studies were analysed. DKA cases in SGLT2i users had lower odds of prior DKA and insulin use. Compared with DKA cases in non-users, SGLT2i users had lower glucose, HbA1c, creatinine, and lactate levels. No significant differences were found in the length of hospitalisation, intensive care unit admission, or in-hospital mortality.
These findings provide quantitative evidence of the distinct clinical features of SGLT2i-associated DKA, which may aid in early detection, management, and prevention in clinical practice.
钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）是有效的降糖药物；然而，它们也会增加糖尿病酮症酸中毒（DKA）的风险。由于DKA发病率较低，比较SGLT2i使用者和非使用者之间DKA特征的临床证据仍然有限，本研究旨在通过系统评价和荟萃分析比较SGLT2i使用者和非使用者DKA的临床特征和结局。
2025年2月在PubMed、Scopus和科学网中检索相关研究。纳入比较SGLT2i使用者和非使用者之间DKA临床特征或结局的研究。使用二元变量的比值比和连续变量的均值差得出合并估计值。
共分析了9项研究。SGLT2i使用者发生DKA的病例既往发生DKA和使用胰岛素的几率较低。与非使用者的DKA病例相比，SGLT2i使用者的血糖、糖化血红蛋白、肌酐和乳酸水平较低。在住院时间、入住重症监护病房或院内死亡率方面未发现显著差异。
这些发现为SGLT2i相关DKA的独特临床特征提供了定量证据，这可能有助于临床实践中的早期检测、管理和预防。
