계명대학교 의학도서관 Repository

Ketoacidosis with euglycemia in a patient with type 2 diabetes mellitus taking dapagliflozin

Metadata Downloads
Author(s)
백진혁박우영한승엽박성배진규복
Alternative Author(s)
Paek, Jin HyukPark, Woo YoungHan, Seung YeupPark, Sung BaeJin, Kyu Bok
Publication Year
2019
Keyword
dapagliflozinketoacidosisrenal replacement therapySGLT2 inhibitor
Abstract
Rationale:
Dapagliflozin (a sodium-glucose cotransporter-2 [SGLT2] inhibitor) represents the most recently approved class of oral medications for the treatment of type 2 diabetes. Dapagliflozin lowers plasma glucose concentration by inhibiting the renal reuptake of glucose in the proximal renal tubules. In 2015, the US Food and Drug Administration released a warning concerning a potential increased risk of ketoacidosis in patients taking this medication.

Patient concerns:
We present the case of a 23-year-old woman with type 2 diabetes treated with dapagliflozin (10mg, once a day) for 2 years who presented to the emergency department with abdominal pain.

Diagnoses:
We diagnosed her with severe ketoacidosis with a normal glucose level (177 mg/dL) due to dapagliflozin, accompanying acute pancreatitis due to hypertriglyceridemia. We concluded that the precipitating factor for euglycemic ketoacidosis was pseudomembranous colitis.

Interventions:
She was treated with intravenous infusions of insulin, isotonic saline, and sodium bicarbonate as diabetic ketoacidosis treatment.

Outcomes:
She was in shock with severe metabolic acidosis. After continuous renal replacement therapy, the uncontrolled metabolic ketoacidosis was treated, and she is currently under follow-up while receiving metformin (500mg, once a day) and shortand long-acting insulins (8 units 3 times and 20 units once a day).

Lessons:
We report an unusual case of SGLT2 inhibitor-induced euglycemic ketoacidosis recovered by continuous renal replacement therapy in a patient with type 2 diabetes and recurrent acute pancreatitis due to hypertriglyceridemia. We diagnosed a rare complication of the SGLT2 inhibitor in a patient with type 2 diabetes in whom uncontrolled metabolic ketoacidosis could be effectively managed via continuous renal replacement therapy.
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine (의과대학)
Citation
Medicine (Baltimore)., Vol.98(3) : e14150-e14150, 2019
Type
Article
ISSN
1536-5964
DOI
10.1097/MD.0000000000014150
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/41909
Authorize & License
  • AuthorizeOpen
Files in This Item:

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.