A Case of Diabetic Ketoacidosis Induced by Sodium-Glucose Cotransporter 2 Inhibitor.

Jun,  Jae Hyuck; Choe,  Kyung Jin; Woo,  Yeong Min; Park,  Ye Rim; Park,  Yoon Kyoo; Kim,  Won Jun; Shim,  Myoung Sook; Kim,  Jin Yeob

doi:2015.16.4.310

J Korean Diabetes > Volume 16(4); 2015 > Article

Case Report

The Journal of Korean Diabetes 2015;16(4):310-314.
DOI: https://doi.org/10.4093/jkd.2015.16.4.310 Published online December 24, 2015.

Sodium-Glucose Cotransporter 2 억제제 사용 후 발생한 케톤산증 1예

전제혁, 최경진, 우영민, 박예림, 박윤규, 김원준, 심명숙, 김진엽

A Case of Diabetic Ketoacidosis Induced by Sodium-Glucose Cotransporter 2 Inhibitor.

Jae Hyuck Jun, Kyung Jin Choe, Yeong Min Woo, Ye Rim Park, Yoon Kyoo Park, Won Jun Kim, Myoung Sook Shim, Jin Yeob Kim

Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea. kozmozman@gnah.co.kr

Abstract

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a new class of oral antihyperglycemic drugs; inhibition of the cotransporter allows for increased renal glucose excretion that consequently leads to reduced plasma glucose level. We report a rare case of a 73-year-old woman with type 2 diabetes mellitus who developed severe ketoacidosis caused by an SGLT2 inhibitor. At admission, severe ketoacidosis with arterial PH 6.99 was observed, though her serum glucose level of 232 mg/dL was not excessively high. It is necessary to pay attention to patients with type 2 diabetes being treated with an SGLT2 inhibitor, as anorexia, diarrhea, dehydration, and weight loss can develop in conjunction with a high fat/protein diet.

Key Words: Diabetes mellitus, Ketosis, Sodium-glucose cotransporter 2