ABCD has produced a position statement on the risk of diabetic ketoacidosis associated with the use of sodium-glucose cotransporter-2 inhibitors. The key messages are shown below:
- The use of SGLT-2 inhibitors is associated with a small but increased risk of diabetic ketoacidosis in both type 1 and type 2 diabetes.
- Caution should be exercised when using SGLT-2 inhibitors in patients who are at high risk of ketoacidosis due to other reasons like dehydration, stress, admission into hospital for elective surgery, trauma, acute medical illness or any other catabolic state.
- Blood glucose levels may not be elevated in SGLT-2 inhibitor associated ketoacidosis and the diagnosis can be missed.
- Treatment of SGLT-2 inhibitor associated ketoacidosis may require a variable, rather than a fixed, rate intravenous insulin infusion and intravenous dextrose to prevent hypoglycaemia.
- The use of SGLT-2 inhibitors in type 1 diabetes, outside of clinical trials, is currently not recommended.
- Local systems and prompts should be introduced to warn both patients and health care professionals about the risk of SGLT-2 inhibitor associated ketoacidosis.
For full details see HERE
