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Intraoperative Diagnosis of Sodium-Glucose Transporter-2 Inhibitor-Associated Euglycemic Diabetic Ketoacidosis.
Cureus
October 2024
Cardiac Anesthesiology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, USA.
Article Synopsis
- * A case study details a 60-year-old man with type 2 diabetes and metastatic melanoma who developed euglycemic diabetic ketoacidosis (DKA) during and after brain surgery, despite having normal blood sugar levels.
- * Effective management of euglycemic DKA involves recognizing its subtle symptoms, administering intravenous insulin with dextrose, correcting metabolic issues, and stopping SGLT2i use, especially in surgical settings.
Successful renal replacement therapy of extreme ertugliflozin and alcohol induced euglycaemic ketoacidosis.
Acta Diabetol
November 2024
Integrated Research and Treatment Center AdiposityDiseases (IFB), University of Leipzig, Leipzig, Germany.
The peri-operative implications of sodium-glucose co-transporter 2 inhibitors: a narrative review.
Anaesthesia
January 2025
Department of Anaesthesiology, University of Hong Kong, Hong Kong.
Introduction: Sodium-glucose co-transporter 2 inhibitors are a novel class of antihyperglycaemic drugs used in the management of type 2 diabetes, that improve glycaemic control, cardiovascular outcomes and promote weight loss. They are also approved for the treatment of heart failure and chronic kidney disease in patients with or without diabetes. This narrative review discusses the peri-operative effects and implications of sodium-glucose co-transporter 2 inhibitors and gives an overview of current evidence and existing peri-operative guidelines.
View Article and Find Full Text PDFMetabolic acidosis in patients with diabetes 2 undergoing cardiac surgery: The impact of SGLT2 inhibitor use: a retrospective cohort study.
Eur J Anaesthesiol
February 2025
From the Department of Anaesthesia and Intensive Care (HKB, GH, ES, MF), the Department of Medicine (MCA), the Section of Cardiothoracic Surgery, Department of Heart Disease, Haukeland University Hospital (RH), the Clinical Institute 2, Medical Faculty, University of Bergen (RH), the Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway (FZG).
Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2-i) lower blood sugar and reduce cardiovascular events and kidney failure. However, there have been increasing reports of euglycaemic diabetic ketoacidosis (eDKA) linked to SGLT2-i medicines.
Objective: Investigating the association between SGLT2-i use and the incidence of metabolic acidosis in patients with type 2 diabetes undergoing cardiac surgery.
Management of diabetes-related hyperglycaemic emergencies in advanced chronic kidney disease: Review of the literature and recommendations.
Diabet Med
July 2024
Department of Diabetes, King's College Hospital NHS Foundation Trust, London, UK.
Aims: Despite the substantial progress in the management of diabetes mellitus (DM), chronic kidney disease (CKD) remains one of the most common complications. Although uncommon, diabetic emergencies [diabetic ketoacidosis (DKA), hyperosmolar hyperglycaemic state (HHS)] can still occur in stage 4 and 5 CKD, at times with less typical clinical manifestations due to the altered pathophysiology, presence of chronic metabolic acidosis and effect of haemodialysis on glycaemic control and metabolic parameters. The purpose of this article is to review the current literature and provide recommendations for the diagnosis and treatment of DKA, euglycaemic DKA and HHS in people with advanced CKD.
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