ReviewCureus2021
Euglycemic Diabetic Ketoacidosis and Sodium-Glucose Cotransporter-2 Inhibitors: A Focused Review of Pathophysiology, Risk Factors, and Triggers.
Review in Cureus, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 57 citations in OpenAlex.
- Hypophosphatemia in Diabetic Ketoacidosis During Intensive Care Admission.Medical sciences (Basel, Switzerland) · 2026Article
- [Hospital diabetes management (Update 2026)].Wiener klinische Wochenschrift · 2026Review
- Euglycemic Diabetic Ketoacidosis: Clinical Suspicion and Diagnosis.Clinical medicine insights. Endocrinology and diabetes · 2026Review
- Spectrum of veterinary care in feline diabetes mellitus.Journal of feline medicine and surgery · 2026Review
- Diagnostic and Management Pitfalls of SGLT2 Inhibitor-Associated Ketoacidosis in the ICU: Lessons Following Cardiac Surgery and GLP-1 Agonist Interaction.Case reports in critical care · 2026Article
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- Article
- Article
- SGLT2 Inhibitors: From Structure-Effect Relationship to Pharmacological Response.International journal of molecular sciences · 2025Review
- Review
- Evolving Clinical Features of Diabetic Ketoacidosis: The Impact of SGLT2 Inhibitors.Pharmaceuticals (Basel, Switzerland) · 2024Article
- Intraoperative Diagnosis of Sodium-Glucose Transporter-2 Inhibitor-Associated Euglycemic Diabetic Ketoacidosis.Cureus · 2024Article
- Article
- Euglycemic diabetic ketoacidosis in the setting of acute intracerebral hemorrhage.Surgical neurology international · 2024Article
- Novel Approach to Continuation of Elective Procedures in People at Risk for Sodium-Glucose Cotransporter 2 Inhibitor-Associated Euglycemic Ketoacidosis.Diabetes spectrum : a publication of the American Diabetes Association · 2024Article
- The lower incidence of cervical cancer in type 2 diabetes mellitus with sodium-glucose cotransporter 2 inhibitors utilization.Journal of Cancer · 2024Article
- Article
- Ketone Bodies in Diabetes Mellitus: Friend or Foe?Nutrients · 2023Review
- Euglycemic diabetic ketoacidosis in the era of SGLT-2 inhibitors.BMJ open diabetes research & care · 2023Review
- [Position statement: surgery and diabetes mellitus (Update 2023)].Wiener klinische Wochenschrift · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 7 institutions in 7 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Diabetic ketoacidosis (DKA) is an acute and significant life-threatening complication of diabetes. The association of sodium-glucose cotransporter-2 inhibitors (SGLT2i) with euglycemic diabetic ketoacidosis (EDKA) has been well reported. This literature review was conducted to understand the mechanism of EDKA and identify the potential risk factors and precipitants for patients taking SGLT2i. After reviewing the published literature between 2010 and 2020, 32 articles are included in the final review. The underlying mechanism is mainly enhanced lipolysis and ketone body reabsorption. SGLT2i also stimulates pancreatic alpha cells and inhibits beta cells, causing an imbalance in glucagon/insulin levels, further contributing to lipolysis and ketogenesis. Most patients were diagnosed with blood glucose less than 200 mg/dL, blood pH <7.3, increased anion gap, increased blood, or urine ketones. Perioperative fasting, pancreatic etiology, low carbohydrate or ketogenic diet, obesity, and malignancy are identified precipitants in this review. As normoglycemia can conceal the underlying acidosis, physicians should be cognizant of the EDKA diagnosis and initiate prompt treatment. Patient education on risk factors and triggers is recommended to avoid future events.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.