Dapagliflozin-induced Postoperative Euglycemic Diabetic Ketoacidosis: Two Cases

Dapagliflozin引起術後正常血糖之糖尿病酮酸中毒：兩例個案報告暨文獻回顧

蔡孟格(Meng-Ko Tsai) ； 陳冠良(Guan-Liang Chen) ； 莊宗儒(Tsung-Ju Chuang)

《內科學誌》 30卷1期 (2019/02) Pp. 47-50

https://doi.org/10.6314/JIMT.201902_30(1).09

摘要

The most common side effect of sodium-glucose co-transporter 2 (SGLT2) inhibitors is genital tract infections. However, a few case reports have shown that their use may induce postoperative euglycemic diabetic ketoacidosis (DKA). Herein, we report two cases of patients who received SGLT2 inhibitor dapagliflozin preoperatively; DKA developed a few days after the operation. To the best of our knowledge, these cases are the first and second reported cases of dapagliflozin-induced DKA after orthopedic surgery. We suggest changing the use of SGLT2 inhibitors to the use of insulin preoperatively and adequate fluid replacement to prevent this life-threatening complication.

關鍵字

Diabetic ketoacidosis ； Dapagliflozin ； Sodium-glucose co-transporter 2 inhibitors

並列摘要

使用鈉－葡萄糖共轉運蛋白2（SGLT2）抑制劑的最常見副作用是生殖道感染。然而，一些個案報告顯示它們的使用可能引起術後正常糖尿病酮酸中毒。在此，我們報告了2例術前接受SGLT2抑製制劑dapagliflozin的患者；糖尿病酮酸中毒在手術後幾天發生。據我們所知，這些個案是第一次和第二次報告的dapagliflozin引起的骨科手術後糖尿病酮酸中毒的個案。我們建議將術前SGLT2抑制劑改為胰島素以及適度的水分補充以預防這種危及生命的併發症。