Beyond the Benefits: A Case Study on the Complications of Sodium-Glucose Co-Transporter-2 (SGLT2) Inhibitors (Euglycemic Diabetic Ketoacidosis (DKA) and Takotsubo Cardiomyopathy).

除了好处 ： 钠 - 葡萄糖共转运蛋白 - 2 （ SGLT2 ） 抑制剂 （ 常血糖糖尿病酮症酸中毒 （ DKA ） 和 Takotsubo 心肌病 ） 并发症的案例研究。

• 发表时间: 2024 Feb
• 来源期刊: Cureus
• DOI: 10.7759/cureus.55068
• PMID: 38550506
• 文章类型: Case Reports
• 作者列表: Sabanci R,Saaed M,Bandi A,Das K,Wilcox M

关键词: canagliflozin; euglycemic diabetic ketoacidosis; heart failure; medication side effect; sglt2 inhibitors; side effect; takotsubo cardiomyopathy (tc)

Abstract

Sodium-glucose co-transporter-2 (SGLT2) inhibitors, integral in type 2 diabetes mellitus (T2DM) management, are not without risks, with reported adverse effects including euglycemic diabetic ketoacidosis (EDKA). We present a case of a 75-year-old female with T2DM on canagliflozin, who developed altered mental status (AMS), nausea, vomiting, and hypotension. The laboratory results revealed ketoacidosis, elevated troponins, and Takotsubo cardiomyopathy (TC), prompting the cessation of canagliflozin. This paradoxical EDKA case underscores the necessity for cautious prescribing. Additionally, our discussion delves into the risk factors, mechanisms, and epidemiology of EDKA associated with SGLT2 inhibitors (SGLT2i), emphasizing the importance of individualized medicine and shared decision-making in their use, despite their proven cardiovascular benefits.

摘要

钠-葡萄糖协同转运蛋白-2（SGLT2）抑制剂，2型糖尿病（T2DM）管理积分，并非没有风险，报告的不良反应包括正常血糖糖尿病酮症酸中毒（EDKA）。我们介绍了一例75岁女性使用canagliflozin治疗T2DM，出现精神状态改变(AMS)的人，恶心,呕吐,和低血压。实验室结果显示酮症酸中毒,肌钙蛋白升高,和Takotsubo心肌病（TC），促使canagliflozin停止.这个矛盾的EDKA案例强调了谨慎处方的必要性。此外,我们的讨论深入研究了风险因素，机制,与SGLT2抑制剂（SGLT2i）相关的EDKA的流行病学，强调个体化医疗的重要性和使用中的共同决策，尽管它们已被证明对心血管有好处。