Dapagliflozin (SGLT2-i) induced euglycaemic diabetic ketoacidosis

BMJ Case Rep. 2019 Sep 19;12(9):e231104. doi: 10.1136/bcr-2019-231104.

Abstract

Sodium glucose co-transporter-2 inhibitors (SGLT2-i) have become a popular therapeutic strategy in the management of hyperglycaemia in type 2 diabetes mellitus. The primary site of action of SGLT2-i is at the proximal renal convoluted tubule. They work by blocking SGLT2 receptors, sodium-dependent glucose co-transport molecules, which in turn prevents glucose reabsorption, facilitating glucosuria, improving glycaemic control as well as a moderate degree of weight loss. We report the case of a 51-year-old woman admitted to the acute medical unit with abdominal pain and vomiting, who was diagnosed with euglycaemic diabetic ketoacidosis secondary to recent initiation of an SGLT2-i medication (dapagliflozin). Clinicians should be aware of this rare side effect of SGLT2-i, to circumvent delays in patient management.

Keywords: Diabetes; Drugs: Endocrine System; Unwanted Effects / Adverse Reactions.

Publication types

  • Case Reports

MeSH terms

  • Benzhydryl Compounds / adverse effects*
  • Blood Glucose
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetic Ketoacidosis / chemically induced*
  • Female
  • Glucosides / adverse effects*
  • Humans
  • Hyperglycemia / drug therapy
  • Kidney Tubules, Proximal / drug effects
  • Middle Aged
  • Sodium-Glucose Transporter 2 Inhibitors / adverse effects*

Substances

  • Benzhydryl Compounds
  • Blood Glucose
  • Glucosides
  • Sodium-Glucose Transporter 2 Inhibitors
  • dapagliflozin