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Q. Can we use SGLT2 inhibitors in Ketosis prone type 2 diabetes ?
- The answer is a No
- But there are no clear studies on the use of SGLT2i in this particular population
- Here's a summary of the consensus from the studies published in 2023:
- SGLT2 inhibitors are effective in managing type 2 diabetes but are associated with an increased risk of diabetic ketoacidosis (DKA), especially in ketosis-prone individuals.
- Severe ketoacidosis can occur without the usual hyperglycemia, making diagnosis challenging and potentially delaying treatment.
- Probable triggering causes for ketoacidosis in patients using SGLT2 inhibitors include recent surgery, with some cases lacking typical DKA triggers.
- Hospital providers need to develop strategies for preventing DKA in hospitalized patients on SGLT2 inhibitors and provide guidance on monitoring and treating euglycemic DKA.
- SGLT2 inhibitors may have renal and cardiovascular benefits, including improved cardiac muscle requirements and antihypertensive effects independent of renal function.
- The cardioprotective effects of SGLT2 inhibitors in the treatment of heart failure are increasingly recognized, beyond their glucose-lowering capabilities.
- Despite their benefits, SGLT2 inhibitors should be used with caution during periods of acute illness due to the risk of insufficient insulin levels leading to ketoacidosis.
- Education and awareness among healthcare professionals and patients about the potential association between SGLT2 inhibitor use and ketoacidosis are essential.
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