ArticleScientific reports2021
SGLT-2 inhibitors associated euglycemic and hyperglycemic DKA in a multicentric cohort.
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.
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Who cites it
58 citing papers in PubMed, 6 syntheses or guidelines pooled it, 78 citations in OpenAlex.
- Sodium glucose co-transporter 2 inhibitor-associated euglycaemic diabetic ketoacidosis in the emergency peri-operative period: a systematic review.Journal of anesthesia · 2025Pooled it
- Sodium-Glucose Cotransporter-2 Inhibitors in Liver Cirrhosis: A Systematic Review of Their Role in Ascites Management, Slowing Disease Progression, and Safety.International journal of molecular sciences · 2025Pooled it
- A systematic literature review on the burden of diabetic ketoacidosis in type 2 diabetes mellitus.Diabetes, obesity & metabolism · 2025Pooled it
- Is Breath Best? A Systematic Review on the Accuracy and Utility of Nanotechnology Based Breath Analysis of Ketones in Type 1 Diabetes.Biosensors · 2025Pooled it
- Sodium-glucose cotransporter 2 inhibitor-associated perioperative ketoacidosis: a systematic review of case reports.Journal of anesthesia · 2023Pooled it
- Right Heart Function in Cardiorenal Syndrome.Current heart failure reports · 2022Pooled it
- Effect of dapagliflozin on mineral homeostasis in patients with type 2 diabetes: A real-world retrospective cohort study.Journal of Taibah University Medical Sciences · 2026Article
- Inflammatory Biomarkers and Their Associations with Arrhythmic Burden Following SGLT2-I Treatment in Chronic Heart Failure-A Subanalysis of the ERASe Trial.Journal of clinical medicine · 2026Article
- Phenome-wide analysis of downstream health outcomes following second-line antidiabetic agent prescriptions in All of Us.Nature communications · 2026Article
- Review
- [Case report of euglycemic diabetic ketoacidosis during SGLT-2 inhibition in a female geriatric patient: sick-day-off drug].Zeitschrift fur Gerontologie und Geriatrie · 2026Article
- Euglycemic Diabetic Ketoacidosis: Clinical Suspicion and Diagnosis.Clinical medicine insights. Endocrinology and diabetes · 2026Review
- 13. Older Adults: Standards of Care in Diabetes-2026.Diabetes care · 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
- Declining incidence of hypoglycaemia in diabetes secondary to chronic pancreatitis: A nationwide cohort study from 2003 to 2022.Diabetes, obesity & metabolism · 2025Article
- Stereotypical diagnostic bias for alcohol-induced ketoacidosis could lead to death: Normal blood sugar levels in SGLT2 blocker-induced severe diabetic ketoacidosis.PCN reports : psychiatry and clinical neurosciences · 2025Article
- SGLT2 Inhibitors and Liver Cirrhosis: Hype or Hope?Life (Basel, Switzerland) · 2025Review
- SGLT2i-induced euglycemic diabetic ketoacidosis in a heart failure patient with acute myocardial infarction: a case report.Annals of medicine and surgery (2012) · 2025Article
- Article
- 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 · 2025Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
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.
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