SynthesisJournal of anesthesia2023
Sodium-glucose cotransporter 2 inhibitor-associated perioperative ketoacidosis: a systematic review of case reports.
Synthesis in Journal of anesthesia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled 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.
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
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 46 citations in OpenAlex.
- A Systematic Review and Expert Evaluation of Perioperative SGLT2 Inhibitor-Associated Ketoacidosis Case Reports.Acta anaesthesiologica Scandinavica · 2026Pooled it
- Guideline
- Article
- Perioperative screening and management of hyperglycemia: a joint position statement from the Brazilian Diabetes Society (SBD), the Brazilian Society of Anesthesiology (SBA) and the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO).Diabetology & metabolic syndrome · 2026Review
- Risk of Euglycemic Diabetic Ketoacidosis Can Persist After Discontinuation of Sodium-glucose Cotransporter-2 Inhibitors.JCEM case reports · 2025Article
- Article
- A cross-sectional survey of knowledge regarding sodium-glucose co-transporter 2 inhibitors (SGLT2is) among primary care physicians and pharmacists in China.Journal of pharmaceutical health care and sciences · 2025Article
- Non-insulin diabetes medicines: a narrative review for anaesthetists and intensivists.British journal of anaesthesia · 2025Review
- New therapeutic agents for type 2 diabetes: anaesthetic considerations. A narrative review.Anaesthesiology intensive therapy · 2025Review
- Review
- Factors and preventive strategies for perioperative euglycemic diabetic ketoacidosis in patients with type 2 diabetes receiving sodium-glucose cotransporter 2 inhibitors: a retrospective study.Journal of pharmaceutical health care and sciences · 2025Article
- Article
- A case of perioperative euglycemic ketoacidosis in a patient without diabetes: are current guidelines enough?Perioperative medicine (London, England) · 2025Article
- Metabolic and Pharmacokinetic Profiling of a Ketone Ester by Background SGLT2 Inhibitor Therapy in HFrEF.JACC. Basic to translational science · 2025Article
- Screening and management of hospital hyperglycemia in non-critical patients: a position statement from the Brazilian Diabetes Society (SBD).Diabetology & metabolic syndrome · 2025Review
- Euglycemic Ketoacidosis Associated with SGLT-2 Inhibitors in Non-diabetic Patients-A Narrative Review.Journal of general internal medicine · 2025Review
- Preoperative management of diabetes mellitus: A comparative narrative review of the recommendations of three professional organizations with Hamad Medical Corporation guidelines.Qatar medical journal · 2025Article
- Empagliflozin Use in Cardiac Transplant Patients:Sultan Qaboos University medical journal · 2025Article
- Remission of type 2 diabetes: position statement of the Italian society of diabetes (SID).Acta diabetologica · 2024Article
- Incidence of sodium-glucose cotransporter-2 inhibitor-associated perioperative ketoacidosis in surgical patients: a prospective cohort study.Journal of anesthesia · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Although the recommended preoperative cessation period for sodium-glucose cotransporter 2 inhibitors (SGLT2is) changed in 2020 (from 24 h to 3-4 days preoperatively) to reduce the risk of SGLT2i-associated perioperative ketoacidosis (SAPKA), the validity of the new recommendation has not been verified. Using case reports, we assessed the new recommendation effectiveness and extrapolated precipitating factors for SAPKA. We searched electronic databases up to June 1, 2022 to assess SAPKA (blood pH < 7.3 and blood or urine ketone positivity within 30 days postoperatively in patients taking SGLT2i). We included 76 publications with 99 cases. The preoperative SGLT2i cessation duration was reported for 59 patients (59.6%). In all cases with available cessation periods, the SGLT2is were interrupted < 3 days preoperatively. No SAPKA cases with > 2-day preoperative cessation periods were found. Many case reports lack important information for estimating precipitating factors, including preoperative SGLT2i cessation period, body mass index, baseline hemoglobin A1c level, details of perioperative fluid management, and type of anesthesia. Our study suggested that preoperative SGLT2i cessation for at least 3 days could prevent SAPKA. Large prospective epidemiologic studies are needed to identify risk factors for SAPKA.
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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.