Cetoacidosis diabética e inhibidores del cotransportador de sodio y glucosa 2¿qué debemos saber?

Abstract

Diabetic ketoacidosis related to sodium glucose cotransporter-2 (SGLT2) inhibitors is a rare but potentially serious complication. Outside of a clinical context that leads to suspicion of diabetic ketoacidosis a priori, the diagnosis is challenging. Treatment requires insulin given at an injection rate able to inhibit the production of ketone bodies, the process causing the problem; glucose must be concomitantly administered in many cases. Diabetic ketoacidosis can be avoided by knowing which patients are at greatest risk for this complication before prescribing SGLT2 inhibitors and by refraining from reducing the patient’s usual insulin dose regimen or carbohydrate intake. It is also essential to equip the patient with information, such as possible precipitating factors and how to detect and treat ketosis in its early stages. Emergency departments should test for high ketone body concentrations in blood during the initial evaluation of patients who are on SGLT2 inhibitors.