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Sglt2 Inhibitors And Dka

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Sglt2 Inhibitors And Diabetic Ketoacidosis: What's Behind The Fda Warning

With commentary by Yehuda Handelsman, MD, FACP, FACE, FNLA, an endocrinologist in private practice in Tarzana, CA, Medical Director and Principal Investigator of the Metabolic Institute of America and President of the American College of Endocrinology People with diabetes who take blood sugar-lowering drugs called SGLT2 inhibitors were recently warned by the U.S. Food and Drug Administration (FDA) that they should watch for signs of a life-threatening condition called diabetic ketoacidosis. canagliflozin (Invokana) dapagliflozin (Farxiga) empagliflozin (Jardiance) as well as the combination pills: canagliflozin plus metformin (Invokamet) dapagliflozin plus metformin extended-release (Xigduo XR) empagliflozin plus linagliptin (Glyxambi). “Diabetic ketoacidosis (DKA) can be deadly,” says Amy Hess-Fischl, MS, RD, LDN, BC-ADM, CDE, an advanced practice dietitian at the University of Chicago Kovler Diabetes Center and a member of EndocrineWeb’s advisory board. “DKA is usually more of a concern for people with type 1 diabetes, but this warning is for people with type 2 diabetes who are taking the SGLT2 inhibitors, as well as people with type 1 diabetes who take these medications Continue reading >>

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Popular Questions

  1. kgros004

    Hey, folks! A few weeks ago, during the holidays, I started noticing some pain in my right side. I decided to pass it off as a crappy diet from all of the parties and restaurants. I had done keto successfully a few times, so once the year started, I was excited to get to brass tacks again. The pain hadn't subsided, but I was hoping getting my diet on the straight and narrow would help. Keto has always helped my digestive track run like a well-oiled machine.
    Yesterday, I had to leave work early because the pain was so bad, it was disrupting my ability to do what I needed to do. I decided to go to the local ER because I wanted answers that day. After some friendly doctors and lots of painful poking, I found out that I have gallstones. It's been a huge bummer because I've loved doing keto! I even had an awesome week of meals planned!
    I tried eating our Mexican Cheesy Chicken last night, and had probably one of the most painful experiences of my life. I am currently figuring things out with work so I can get my gallbladder removed. What should I do in the interim? There's a lot of confusing arguments and science about low carb and low fat and the gallbladder, but I just want real advice from a real live person whose really been there.
    tl;dr: Doing great on keto! Got diagnosed with gallstones. What do I eat?

  2. otismatis

    I just want real advice from a real live person whose really been there.
    I may be the wrong person, because I actually think I am the doc who saw you in the ER yesterday. We discussed Portal 2.
    Rapid weight loss can actually exacerbate gallbladder problems. I would eat a pretty mild diet over the next few weeks, and get your gallbladder out. I see patient after patient at my primary care clinic, and most of our efforts are focused on trying to manage the damage to their bodies from a poor diet. If I could go back in time and make them follow a keto diet with lots of veggies, I would do it for every one of my patients.
    So, take it easy on fats until your gallbladder is out, and then get back on keto, and stay on it.
    Good luck buddy!

  3. kgros004

    Holy crap on a cracker! That was me! I should have mentioned keto while I was there! Thanks, doc!

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