Case of ketoacidosis by a sodium‐glucose cotransporter 2 inhibitor in a diabetic patient with a low‐carbohydrate diet

We present a case of a 32‐year‐old diabetic woman with Prader–Willi syndrome who developed severe ketoacidosis caused by a sodium‐glucose cotransporter 2 (SGLT2) inhibitor, a novel class of antihyperglycemic agents, during a strict low‐carbohydrate diet. At admission, a serum glucose level of 191 mg...

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Published in:Journal of diabetes investigation 2015-09, Vol.6 (5), p.587-590
Main Authors: Hayami, Tomohide, Kato, Yoshiro, Kamiya, Hideki, Kondo, Masaki, Naito, Ena, Sugiura, Yukako, Kojima, Chika, Sato, Sami, Yamada, Yuichiro, Kasagi, Rina, Ando, Toshihito, Noda, Saeko, Nakai, Hiromi, Takada, Eriko, Asano, Emi, Motegi, Mikio, Watarai, Atsuko, Kato, Koichi, Nakamura, Jiro
Format: Article
Language:English
Subjects:
Carbohydrates
Cholesterol
Diabetes
Diabetes mellitus
Diabetic ketoacidosis
Diet
Glucose
Hemoglobin
Insulin
Ketoacidosis
Laboratories
Low carbohydrate diet
Na+/glucose cotransporter
Nutrient deficiency
Patients
Peptides
Prader-Willi syndrome
Proteins
Sediments
Sodium
Sodium‐glucose cotransporter 2 inhibitor
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Summary:We present a case of a 32‐year‐old diabetic woman with Prader–Willi syndrome who developed severe ketoacidosis caused by a sodium‐glucose cotransporter 2 (SGLT2) inhibitor, a novel class of antihyperglycemic agents, during a strict low‐carbohydrate diet. At admission, a serum glucose level of 191 mg/dL was relatively low, though laboratory evaluations showed severe ketoacidosis. This is the first report of ketoacidosis caused by a SGLT2 inhibitor. It is necessary to not only pay attention when using a SGLT2 inhibitor in patients following a low‐carbohydrate diet, but also to start a low‐carbohydrate diet in patients treated with a SGLT2 inhibitor because of a high risk for developing ketoacidosis. This is the first report of ketoacidosis caused by a SGLT2 inhibitor. It is necessary to pay attention not only to use a SGLT2 inhibitor in the patients during a low‐carbohydrate diet but also to start a low‐carbohydrate diet in the patients treated with a SGLT2 inhibitor because of a high risk for developing ketoacidosis.
ISSN:2040-1116
2040-1124
DOI:10.1111/jdi.12330