diabetestalk.net

Sglt Inhibition And Euglycemic Diabetic Ketoacidosis

Share on facebook

Susan Cornell, PharmD, CDE, FAPhA, FAADE, describes the risks for ketoacidosis and serious urinary tract infection associated with use of SGLT2 inhibitors. This video was recorded at APhA's 2016 Annual Meeting and Exposition in Baltimore, Maryland.

Euglycemic Diabetic Ketoacidosis: The Clinical Concern Of Sglt2 Inhibitors

Euglycemic diabetic ketoacidosis is a post market warning in patients with type 1 diabetes and type 2 diabetes treated with SGLT-2 inhibitors. We report a case of a 39-year-old obese female with presumed type 2 diabetes for seven years who presented to the emergency department with three days of nausea, vomiting, and abdominal pain. Due to previous total non-adherence with a prescribed insulin regimen, she was recently started on canagliflozin and liraglutide. The diagnosis of euDKA was missed in the initial evaluation as the blood glucose level was only 167 mg/dL. Further work up showed severe metabolic acidosis with an anion gap of 25 and positive ketones in the urine. She was treated successfully with dextrose water 5%/half normal saline and an insulin drip. As part of the work up, she tested positive for glutamic acid decarboxylase autoantibodies. Given the increasing utilization of SGLT-2 inhibitors and the fact that patients can present with near-normal glycemia, the diagnosis can be missed. Vigilance with the use of SGLT-2 inhibitors is necessary to decrease morbidity and potentially mortality particularly in patients with long-standing type 2 diabetes associated with marked Continue reading >>

Share on facebook

Popular Questions

  1. Joe Joe

    I've heard of people buying them at Wal-Mart, but I was just there and couldn't find any. Maybe I was looking in the wrong section?
    Where do you folks find your ketostix? :)

  2. doreen T

    Any store with a pharmacy will have ketostix (sometimes called lipolysis sticks, or ketone testing strips). Look in the section where they sell diabetic supplies. Some stores have them behind the counter ... apparently they're hot shop-lift items :rolleyes: You don't need a prescription though, so just ask.
    hth,
    Doreen

  3. Joe Joe

    Thanks! I'll have to ask next time.
    Here's a dumb question... how do you pronounce keto? 'kee-to', 'kay-to'??? :o
    Thanks again!

  4. -> Continue reading
read more
Share on facebook

SGLT2 inhibitors show no significant risk of DKA, study reports Follow this link: http://tinyurl.com/6irc9o5ia89 SGLT2 inhibitors show no significant risk of DKA, study reports click here full resolution --- for more information go to-http://tinyurl.com/pvwe7iu879/ Adults with type 2 diabetes who take SGLT2 inhibitors are less likely to experience diabetic ketoacidosis (DKA) than those on insulin treatment, a study suggests.These findings existed for those with type 2 diabetes either prescribed SGLT2 inhibitors as a single treatment or in combination with another drug.Scientists from the Steno Diabetes Center, Copenhagen, Denmark examined 415,670 people with type 2 diabetes during 1995-2017, all of whom were treated with medication, including insulin.They sought to evaluate the rates of DKA within patients to assess if any association could be made between DKA, a dangerous short-term complication, and SGLT2 inhibitors.SGLT2 inhibitors work by helping the kidneys to lower blood glucose levels, with excess blood glucose removed through urine. for more information go to-http://tinyurl.com/82d95inail/ type 2 diabetes, SGLT2 inhibitors, dka

Euglycemic Dka Secondary To Sglt2 Inhibitors

Authors: Priyanka Kailash (MS-4, Campbell University School of Osteopathic Medicine), Kevin Weaver, DO (Program Director, Lehigh Valley Health Network), and Krystle Shafer, MD (Attending Physician, York Hospital) // Edited by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UT Southwestern Medical Center / Parkland Memorial Hospital) and Brit Long, MD (@long_brit) A 35-year-old male with a past medical history of type 2 diabetes arrives at the Emergency Department (ED) with altered mental status, nausea, vomiting, and diffuse abdominal pain that started 10 hours ago. The patient was recently started on an SGLT2 inhibitor. On examination, the patient is tachycardic (HR 126) and tachypneic (RR 25), with normal blood pressure (110/90). He is further noted to have dry mucous membranes and poor skin turgor. Blood glucose is noted to be 140 mg/dl, serum ketones 6.2 mmol/L, and arterial pH of 6.9. The patient is diagnosed with euglycemic DKA and quickly admitted to ICU for treatment. Pathogenesis of Typical DKA Two major complications from type 1 diabetes mellitus and type 2 diabetes mellitus are diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). DKA is typically Continue reading >>

Share on facebook

Popular Questions

  1. AddictedtoCatFace

    I have been on and off keto for about a year now. Started at 5'10 and 210 and down to 165. I normally eat a vegan diet and have no problem getting and maintaining and erection. I've noticed though when I'm deep into Keto that I feel great, no brain fog and lots of energy but I've been have issues keeping an erection or in general getting turned on without direct stimuli. I've researched around and it seems other people have experienced this as well.
    I'm wondering if I may just be too low of carb. I am thinking about integrating some healthy carbs back into my diet such as beans or something of that sort. My conundrum is like sex and have a partner that does too but I also do not what to go out of keto as I feel confident, out going, and generally great while on it.
    If anyone has had this and found anything to help please let me know! Thank you.
    UPDATE: (maybe NSFW but i'll try to keep it G rated): First of all if you have never eaten a meatless / dairy free diet do not ask someone who is if they are getting enough protein. There is a thing called google if you truly care then research, there are tons of resources and books on the subject, but I highly honestly don't think you will. Protip: maybe ask about B12, as it's hard to find in a vegan diet, I take supplements just incase because it can wreck havoc if you are deficient though it's very hard to be deficient in it.
    Now the possibly NSFW part(tl;dr at end): So took the advice of ate a little more, took double dose of vit d(even though I get a good amount of sun here in Southern OR), and put a little carbs in(split a can of chili with my SO). Usually I am around the lower end of 30-50 carbs. I upped it to about 75. Last night had a little fun time with the lady(she also having a harder time getting aroused). It went well but was still sort of a weaker erection than the norm. So I wake up at 5 am with a cat head and paw resting on my erection. I move him off and spoon him instead trying to go back to sleep. My SO wakes up to pee, feeling a bit sick(sore throat, not sure from carbs or coincidence as it happened while integrating more). I tell her I can't sleep and tell her whats going on and that I'm going to relieve said erection. I pee and waste some time browsing reddit/check email all while still maintaining. This started at 6:00 am. About 6:20 I'm like, "oh yeah I need to take care of this". 6:40 business handled but still erect. Stayed that way until about 7:00 am, as I wrote this it started going down... guess my brain needed to borrow some power.
    TL;DR: Increased calories, vit d, and carbs. Woke up with cat cuddling erection. Maintained for 2 hours.

  2. erixsparhawk

    Calorie issue! Just one day a week with a massive keto refeed where you stuff yourself with fat and protein. Will fix your libido problem.

  3. anbeav

    Yup, high deficits will kill libido

  4. -> Continue reading
read more
Share on facebook

I just discovered an app that gives you free mobile load for trying apps on your phone. Just Sign in with google and Download apps Click here to register https://www.pivot.one/app/invite_logi...

Get Unlimited Access On Medscape.

You’ve become the New York Times and the Wall Street Journal of medicine. A must-read every morning. ” Continue reading >>

Share on facebook

Popular Questions

  1. NicoleAnn

    Ketones and Unrinary Tract Infection

    Is it normal when you have a high level of ketone's in your system to get a urinary tract infection? I'm kinda wondering about it, since my doctor doesn't listen to me when I say I have ketone's and he gives me antibiotics for a urinary tract infection. Any help would be greatly appreciated.

  2. MarkM

    Infections are not caused by ketones. But they are encouraged by the high blood sugar that often accompanies ketones. Bacteria love warm moist places where there are lots of nutrients. If you lower your blood sugar to the point there is no longer sugar in your urine, you will be removing one of the key attractions. And hopefully you won't get so many infections. But until this happens, you are going to have to use antibiotics ... .

  3. Kaki

    I already commented on your blog this morning regarding ketones, as an individual who has had many UTI's, women know when they have an infection, as its not possible to urinate without that burning sensation, which we do not tolerate very well and will send you immediately to your doctor for medication to resolve a UTI, you made no mention as to whether you did in fact give your doctor a urine specimen.

  4. -> Continue reading
read more

No more pages to load

Related Articles

  • Sglt Inhibition And Euglycemic Diabetic Ketoacidosis

    Authors: Priyanka Kailash (MS-4, Campbell University School of Osteopathic Medicine), Kevin Weaver, DO (Program Director, Lehigh Valley Health Network), and Krystle Shafer, MD (Attending Physician, York Hospital) // Edited by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UT Southwestern Medical Center / Parkland Memorial Hospital) and Brit Long, MD (@long_brit) A 35-year-old male with a past medical history of type 2 diabetes arrives at t ...

    ketosis May 24, 2018
  • Euglycemic Diabetic Ketoacidosis Symptoms

    Euglycemic Diabetic Ketoacidosis: A Potential Complication of Treatment With SodiumGlucose Cotransporter 2 Inhibition We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. G ...

    ketosis Apr 29, 2018
  • Euglycemic Diabetic Ketoacidosis Treatment

    Craig Cocchio, PharmD, BCPS, is an Emergency Medicine Clinical Pharmacist at Trinity Mother Frances Hospital in Tyler, Texas. Follow on Twitter @iEMPharmD and on his blog at empharmd.blogspot.com Diabetic ketoacidosis (DKA) in patients with presenting serum blood glucose <200 mg/dL isn’t common. More often, it’s seen in patients with type 1 diabetes in conjunction with starvation and acute illness.1 It’s difficult to determine an incidence ...

    ketosis Apr 7, 2018
  • Euglycemic Ketoacidosis Definition

    Go to: Introduction Hyperglycemia and ketosis in diabetic ketoacidosis (DKA) are the result of insulin deficiency and an increase in the counterregulatory hormones glucagon, catecholamines, cortisol, and growth hormone. Three processes are mainly responsible for hyperglycemia: increased gluconeogenesis, accelerated glycogenolysis, and impaired glucose utilization by peripheral tissues. This might also be augmented by transient insulin resistance ...

    ketosis Apr 25, 2018
  • Euglycemic Ketoacidosis Mechanism

    To the Editor: Inhibitors of sodium–glucose cotransporter 2 (SGLT2) decrease plasma glucose by blocking the reabsorption of glucose at the proximal tubule.1,2 Case reports have suggested that SGLT2 inhibitors may be associated with an increased risk of diabetic ketoacidosis, which led to a warning from the Food and Drug Administration (FDA) in May 2015.3,4 The objective of our study was to assess the risk of diabetic ketoacidosis after the init ...

    ketosis Apr 27, 2018
  • What Is Euglycemic Diabetic Ketoacidosis?

    Euglycemic diabetic ketoacidosis is a post market warning in patients with type 1 diabetes and type 2 diabetes treated with SGLT-2 inhibitors. We report a case of a 39-year-old obese female with presumed type 2 diabetes for seven years who presented to the emergency department with three days of nausea, vomiting, and abdominal pain. Due to previous total non-adherence with a prescribed insulin regimen, she was recently started on canagliflozin an ...

    diabetes Jan 4, 2018

More in ketosis