A Scandinavian registry study reveals that certain high-risk groups, such as those with high blood glucose, low body weight, or prior ketoacidosis episodes, face persistent risks of severe ketoacidosis while using SGLT2 inhibitors, prompting calls for improved patient screening and safer prescribing practices.
Patients with type 2 diabetes who have high blood glucose, lower body weight or a past episode of ketoacidosis appear to face a greater risk of developing the complication again while taking SGLT2 inhibitors, according to research published in The Lancet Diabetes & Endocrinology and reported by MedicalXpress. The Scandinavian registry study suggests the danger does not fade after the first months of treatment, but remains present for as long as the drugs are used.
SGLT2 inhibitors are widely prescribed because they can help control blood sugar and have added benefits for the heart and kidneys. But the class has also been linked to diabetic ketoacidosis, a rare emergency in which the body produces too many ketones when insulin is too low. The new study, led by Karolinska Institutet researchers and based on data from Sweden, Denmark and Norway, examined more than 280,000 people with type 2 diabetes treated with these medicines.
The researchers found that infection was the most common trigger or accompanying event in ketoacidosis cases. Kidney problems, stroke and major surgery were also seen more often among affected patients. Alongside previous ketoacidosis, high blood glucose, low body mass and signs of malnutrition stood out as important warning signs. Past episodes of hypoglycaemia were linked with increased risk as well.
The findings fit with earlier safety advice from the European Medicines Agency, which has told clinicians to be cautious in patients with factors that can raise the risk of ketoacidosis, including illness, surgery, dehydration and sharp reductions in insulin. Peter Ueda, an assistant professor at Karolinska Institutet, said the aim is not to discourage treatment, but to help doctors identify higher-risk patients and use the drugs more safely. The study’s authors say the next step is to look more closely at who develops ketoacidosis during treatment and to examine other rare serious side effects of modern diabetes medicines.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
