Does Treatment with Sodium-Glucose Cotransporter-2 Inhibitors Affect Adherence to International Society Criteria for Diabetic Ketoacidosis in Adult Patients with Type 2 Diabetes? A Retrospective Cohort Analysis.

Publisher: Wiley Country of Publication: United States NLM ID: 101605237 Publication Model: eCollection Cited Medium: Internet ISSN: 2314-6753 (Electronic) NLM ISO Abbreviation: J Diabetes Res Subsets: MEDLINE

Publication: 2024- : [Hoboken, NJ] : Wiley
Original Publication: Nasr City, Cairo : Hindawi Publishing Corporation, [2013]-

Diabetes Mellitus, Type 2*/complications ; Diabetes Mellitus, Type 2*/drug therapy ; Diabetes Mellitus, Type 2*/chemically induced ; Diabetic Ketoacidosis*/diagnosis ; Sodium-Glucose Transporter 2 Inhibitors*/therapeutic use; Adult ; Humans ; United States ; Adolescent ; Retrospective Studies ; Cohort Studies ; Glucose ; Sodium

Design: Retrospective observational study. Setting . Inpatients at two teaching hospitals in Queensland, Australia. Primary Outcome Measure(s) . The number of patients meeting the Joint British Diabetes Society (JBDS) and American Association of Clinical Endocrinology/American College of Endocrinology (AACE/ACE) diagnostic criteria for DKA. Patients were divided into two groups by treatment with SGLT2i at the time of diagnosis. Participants . Adult patients (>18 years old) with type 2 diabetes diagnosed with DKA from April 2015 to January 2022. Patients without type 2 diabetes were excluded.
Results: One hundred and sixty-five patients were included in this study-comprising 94 patients in the SGLT2i cohort and 70 in the non-SGLT2i cohort. A significantly smaller proportion of patients in the SGLT2i vs. non-SGLT2i cohorts met both JBDS (56% vs. 72%, p = 0.035) and AACE/ACE (63% vs. 82%, p = 0.009) criteria for diagnosis of DKA.
Conclusion: Patients with type 2 diabetes treated with SGLT2i may be more likely to be diagnosed with DKA despite not meeting the criteria. Despite recent adjustments to account the physiological effects of SGLT2i, significant variation in criteria between major society guidelines presents ongoing challenges to clinicians. The proportion of patients diagnosed using both JDBS and AACE/ACE were comparable, suggesting a reasonable degree of agreement.
Competing Interests: The authors declare that they have no conflicts of interest.
(Copyright © 2024 Aongus O'Brolchain et al.)

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0 (Sodium-Glucose Transporter 2 Inhibitors)
IY9XDZ35W2 (Glucose)
9NEZ333N27 (Sodium)

Date Created: 20240322 Date Completed: 20240325 Latest Revision: 20240325

20250114

PMC10957251

10.1155/2024/1849522

38516324