Evidence mapPaperPMID 33986421Full record

ArticleScientific reports2021

SGLT-2 inhibitors associated euglycemic and hyperglycemic DKA in a multicentric cohort.

Fateen Ata, Zohaib Yousaf, Adeel Ahmad Khan, Almurtada Razok, Jaweria Akram, Elrazi Awadelkarim Hamid Ali, Ahmed Abdalhadi, Diaeldin Abdelgalil Ibrahim, Dabia Hamad S H Al Mohanadi, Mohammed I Danjuma

Open access · goldAbstract readMulticenter Study
In one paragraph

Article in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 6 pooled it
8.1field-weighted citation impact, top 2% of its field
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 6 syntheses or guidelines pooled it, 78 citations in OpenAlex.

  1. Pooled it
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  6. Right Heart Function in Cardiorenal Syndrome.Current heart failure reports · 2022
    Pooled it
  7. Article
  8. Article
  9. Article
  10. Review
  11. Article
  12. Euglycemic Diabetic Ketoacidosis: Clinical Suspicion and Diagnosis.Clinical medicine insights. Endocrinology and diabetes · 2026
    Review
  13. Review
  14. Article
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  17. Review
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  20. Oral Semaglutide as an Opportunity for an Appropriate Therapeutic Switch in People with Type 2 Diabetes: A Delphi Consensus.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Fateen AtaDepartment of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, PO BOX 3050, Doha, Qatar.
Zohaib YousafDepartment of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, PO BOX 3050, Doha, Qatar. zohaib.yousaf@gmail.com.
Adeel Ahmad KhanDepartment of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, PO BOX 3050, Doha, Qatar.
Almurtada RazokDepartment of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, PO BOX 3050, Doha, Qatar.
Jaweria AkramDepartment of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, PO BOX 3050, Doha, Qatar.
Elrazi Awadelkarim Hamid AliDepartment of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, PO BOX 3050, Doha, Qatar.
Ahmed AbdalhadiDepartment of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, PO BOX 3050, Doha, Qatar.
Diaeldin Abdelgalil IbrahimDepartment of Geriatrics, Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar.
Dabia Hamad S H Al MohanadiDepartment of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, PO BOX 3050, Doha, Qatar.
Mohammed I DanjumaDepartment of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, PO BOX 3050, Doha, Qatar.
Hamad Medical Corporation · QAHamad General Hospital · QA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Euglycemic diabetic ketoacidosis (EuDKA) secondary to Sodium-glucose co-transporter-2 inhibitors (SGLT2i) in type 2 diabetes mellitus (T2D) is a rare but increasingly reported phenomenon. Not much is known about the burden of EuDKA in patients on SGLT2i or the associated factors. This retrospective cohort study tries to delineate the differences in factors associated with the development of EuDKA as compared to hyperglycemic DKA. We conducted a multicentre, retrospective study across three tertiary care centers under Weill Cornell affiliated-Hamad Medical Corporation, Qatar. The cohort comprised of T2D patients on SGLT2i who developed DKA between January 2015 to December 2020. The differences between the subjects who developed EuDKA or hyperglycaemic DKA (hDKA) were analyzed. A total of 9940 T2D patients were on SGLT2i during 2015-2020, out of which 43 developed DKA (0.43%). 25 developed EuKDA, whereas 18 had hDKA. The point prevalence of EuDKA in our cohort was 58.1%. EuDKA was most common in patients using canagliflozin, followed by empagliflozin and Dapagliflozin (100%, 77%, and 48.3%, respectively). Overall, infection (32.6%) was the most common trigger for DKA, followed by insulin non-compliance (13.7%). Infection was the only risk factor with a significant point estimate between the two groups, being more common in hDKA patients (p-value 0.006, RR 2.53, 95% CI 1.07-5.98). Canagliflozin had the strongest association with the development of EuDKA and was associated with the highest medical intensive care unit (MICU) admission rates (66.6%). In T2D patients on SGLT2i, infection is probably associated with an increased risk of developing EuDKA. The differential role of individual SGLT2i analogs is less clear and will need exploration by more extensive prospective studies.

Indexed as

Blood GlucoseCohort StudiesDiabetes Mellitus, Type 2Diabetic KetoacidosisFemaleHumansHyperglycemiaMaleMiddle AgedSodium-Glucose Transporter 2 InhibitorsBlood GlucoseSodium-Glucose Transporter 2 Inhibitors

Identifiers

PMID33986421
PMCPMC8119406
OpenAlexW3163812846

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

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.