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Prolonged Ketosis In A Patient With Euglycemic Diabetic Ketoacidosis Secondary To Dapagliflozin

Sodium-glucose cotransporter 2 inhibitors (SGLT2) are the newest class of oral agents to receive US Food and Drug Administration (FDA) approval for the treatment of type 2 diabetes (T2DM). SGLT2 inhibitors currently approved by the FDA include canagliflozin, dapagliflozin, and empagliflozin as well as various combination drugs (Table 1). The enthusiasm this class of drugs has been greeted with stems from the benefits associated with SGLT2 inhibitors. They include decrease in A1c by 0.5% to 1%, reduction in insulin doses, modest weight loss, and improved systolic and diastolic blood pressure.1 In addition, the EMPA-REG OUTCOME trial showed a reduction in all-cause and cardiovascular mortality with empagliflozin.2 Also, a post hoc analysis of a study on dapagliflozin in type 2 diabetics with moderate renal impairment showed improved albuminuria and delayed progression to severe renal failure.3 The popularity of SGLT2 inhibitors is understandable considering the paucity of oral diabetic drugs that promote both weight loss and reduction of insulin needs. Endocrinologists and internists alike have increasingly prescribed this class of drugs as to avoid initiation of insulin or escalatio Continue reading >>

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  1. ashsimmonds

    Fun fact: if following the USDA guidelines you can't simultaneously meet both their potassium and sodium intakes.
    http://www.ncbi.nlm.nih.gov/pubmed/23507224

  2. yaterspen

    Geez, TIL indeed. I enjoyed this rather frosty line: "Feasibility studies should precede or accompany the issuing of dietary guidelines to the public." Zing!
    The groups that set the guidelines for millions of people to eat by are hilariously terrible at their job. Obviously they're more influenced by dogma and politics than by science. It's like a kid learning that their parents aren't infallible. I don't know whether to laugh or cry.

  3. ashsimmonds

    BTW, prime TIL karma ammo right there.
    Remember me in your internet point fame speeches...

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