SGLT-2 Inhibitors Raise Incidence of Diabetic Ketoacidosis

But absolute risk increase with sodium–glucose cotransporter-2 inhibitors is small and unlikely to outweigh benefits in high-risk patients.

Sodium–glucose cotransporter-2 (SGLT-2) inhibitors seem to lower risk for heart-failure hospitalizations, renal failure, and early mortality in high-risk patients with type 2 diabetes (NEJM JW Gen Med Aug 1 2020 and Ann Intern Med 2020 Jun 30; [e-pub]). However, reports of excess risk for amputations and Fournier gangrene, and an FDA-issued warning about diabetic ketoacidosis (DKA) associated with SGLT-2 inhibitors, led to concerns about harms associated with these drugs. Observational studies to date have yielded conflicting results. Now, in a retrospective study, investigators compared outpatients (>350,000; from Canada and the U.K.) with type 2 diabetes who were receiving SGLT-2 inhibitors or dipeptidyl peptidase-4 (DPP-4) inhibitors.

Dur…

Reviewing Author

Daniel D. Dressler, MD, MSc, MHM, FACP

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel (2021–2026)

Daniel D. Dressler, MD, MSc, MHM, FACP

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel (2021–2026)

SGLT-2 Inhibitors Raise Incidence of Diabetic Ketoacidosis

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Reviewing Author