SGLT2 Inhibitors and Euglycemic DKA

Risk factors ...
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SGLT2 Inhibitors and Euglycemic DKA



Risk factors for euglycemic DKA in those on an SGLT2i include:

 • Increased insulin requirement (illnesses and surgery)

 • Insulin deficiency

 • Severe dehydration

 • Decreased carbohydrate intake

 • Excessive alcohol consumption

Diagnostic criteria include:

 • Serum pH ≤ 7.3

 • Serum bicarbonate ≤ 15

 • Anion gap > 12

 • Ketones in serum or urine

Treatment involves early recognition along with the following:

 • Correction of dehydration

 • Correction of electrolyte abnormalities, specifically hyper/hypoK

 • Consideration of insulin therapy in severe cases

 • Maintenance of a glucose of 12-15 mmol until the anion gap is closed

 • SGLT2 inhibitor should be held immediately



Kat Watson @Kat_Watson



#SGLT2 #Euglycemic #DKA #EDKA #Toxicity #Toxicology 
Contributed by

Dr. Gerald Diaz
@GeraldMD
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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