{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T08:08:17Z","timestamp":1753862897426,"version":"3.41.2"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T00:00:00Z","timestamp":1726012800000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015401","name":"Key Research and Development Projects of Shaanxi Province","doi-asserted-by":"publisher","award":["2023 ZDLSF 40"],"award-info":[{"award-number":["2023 ZDLSF 40"]}],"id":[{"id":"10.13039\/501100015401","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec><jats:title>Key Clinical Message<\/jats:title><jats:p>High\u2010dose acarbose may increase the risk of diabetic ketosis\/diabetic ketoacidosis in Asian patients on sodium\u2010glucose cotransporter\u20102 inhibitors. Healthcare providers and patients should be cautious to avoid this combination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>Low\u2010calorie diets should be avoided in patients receiving sodium\u2010glucose cotransporter\u20102 (SGLT\u20102) inhibitors to decrease the risk of diabetic ketoacidosis (DKA). High\u2010dose acarbose can decelerate carbohydrate absorption. We detail three cases of diabetic ketosis (DK) following concurrent SGLT\u20102 inhibitor and high\u2010dose acarbose therapy (acarbose 300\u2009mg\/day and dapagliflozin 10\u2009mg\/day). Patients, aged 38\u201363\u2009years with 3\u201310\u2009years of type 2 diabetes mellitus (T2DM), developed DK, indicated by moderate urinary ketones and high glucose (urine ketone 2+ to 3+ and glucose 3+ to 4+) without acidosis, within 4\u2009days to 1\u2009month post\u2010therapy initiation. Serum glucose was 172.8\u2013253.8\u2009mg\/dL; HbA1c was 9.97%\u201310.80%. The combination therapy was halted, and DK was managed with low\u2010dose intravenous insulin and fluids, followed by intensive insulin therapy. High\u2010dose acarbose with SGLT\u20102 inhibitors may increase the risk of DK\/DKA in Asian patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccr3.9282","type":"journal-article","created":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T04:11:53Z","timestamp":1726114313000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>SGLT<\/scp>\u20102 inhibitors and high\u2010dose acarbose as potential high\u2010risk combinations for ketosis and ketoacidosis in Asian patients with <scp>T2DM<\/scp>: A case series"],"prefix":"10.1002","volume":"12","author":[{"given":"Wei","family":"Qiang","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism The First Affiliated Hospital of Xi'an Jiaotong University  Xi'an P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8411-4210","authenticated-orcid":false,"given":"Fei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism The First Affiliated Hospital of Xi'an Jiaotong University  Xi'an P. R. China"},{"name":"Department of Endocrinology The First Affiliated Hospital of Xi'an Medical University  Xi'an P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism The First Affiliated Hospital of Xi'an Jiaotong University  Xi'an P. R. China"},{"name":"Department of Endocrinology Chang Qing Oil Field Worker's Hospital  Xi'an P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruiqing","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism The First Affiliated Hospital of Xi'an Jiaotong University  Xi'an P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yushi","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism The First Affiliated Hospital of Xi'an Jiaotong University  Xi'an P. R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahona","family":"Mondal","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism The First Affiliated Hospital of Xi'an Jiaotong University  Xi'an P. R. 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China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,9,11]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_10_2_1","DOI":"10.2337\/dci19-0066"},{"doi-asserted-by":"publisher","key":"e_1_2_10_3_1","DOI":"10.1007\/s00125-018-4663-6"},{"doi-asserted-by":"publisher","key":"e_1_2_10_4_1","DOI":"10.1016\/j.amjcard.2019.10.029"},{"doi-asserted-by":"publisher","key":"e_1_2_10_5_1","DOI":"10.5694\/mja2.50472"},{"doi-asserted-by":"publisher","key":"e_1_2_10_6_1","DOI":"10.1111\/dom.13740"},{"doi-asserted-by":"publisher","key":"e_1_2_10_7_1","DOI":"10.1111\/dom.13749"},{"doi-asserted-by":"publisher","key":"e_1_2_10_8_1","DOI":"10.2337\/dc18-2316"},{"doi-asserted-by":"publisher","key":"e_1_2_10_9_1","DOI":"10.4158\/EP161292.PS"},{"doi-asserted-by":"publisher","key":"e_1_2_10_10_1","DOI":"10.1210\/jc.2015-1884"},{"doi-asserted-by":"publisher","key":"e_1_2_10_11_1","DOI":"10.2174\/1573399812666160421121307"},{"doi-asserted-by":"publisher","key":"e_1_2_10_12_1","DOI":"10.2337\/dc15-1251"},{"doi-asserted-by":"publisher","key":"e_1_2_10_13_1","DOI":"10.1177\/2324709616663231"},{"doi-asserted-by":"publisher","key":"e_1_2_10_14_1","DOI":"10.2337\/dc13-0598"},{"doi-asserted-by":"publisher","key":"e_1_2_10_15_1","DOI":"10.1111\/jdi.12490"},{"doi-asserted-by":"publisher","key":"e_1_2_10_16_1","DOI":"10.1016\/j.jfma.2018.02.004"},{"doi-asserted-by":"publisher","key":"e_1_2_10_17_1","DOI":"10.1016\/S2213-8587(17)30318-2"},{"doi-asserted-by":"publisher","key":"e_1_2_10_18_1","DOI":"10.1159\/000198755"},{"doi-asserted-by":"publisher","key":"e_1_2_10_19_1","DOI":"10.1002\/dmrr.2827"},{"doi-asserted-by":"publisher","key":"e_1_2_10_20_1","DOI":"10.4093\/dmj.2011.35.5.431"},{"doi-asserted-by":"publisher","key":"e_1_2_10_21_1","DOI":"10.1111\/1753-0407.12337"},{"doi-asserted-by":"publisher","key":"e_1_2_10_22_1","DOI":"10.1038\/s41467-017-01682-2"},{"key":"e_1_2_10_23_1","first-page":"581","article-title":"Sodium\u2010glucose cotransporter 2 inhibitors and euglycemic diabetic ketoacidosis","volume":"21","author":"Liu Min SN","year":"2018","journal-title":"Pract Pharm Clin Remedies"},{"doi-asserted-by":"publisher","key":"e_1_2_10_24_1","DOI":"10.1016\/S2213-8587(13)70050-0"},{"issue":"11","key":"e_1_2_10_25_1","article-title":"Dapagliflozin\u2010induced Late\u2010onset Euglycemic Diabetic Ketoacidosis","volume":"11","author":"Iqbal I","year":"2019","journal-title":"Cureus"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.9282","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T11:20:53Z","timestamp":1734002453000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.9282"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9]]},"references-count":24,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1002\/ccr3.9282"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.9282","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"type":"print","value":"2050-0904"},{"type":"electronic","value":"2050-0904"}],"subject":[],"published":{"date-parts":[[2024,9]]},"assertion":[{"value":"2024-03-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e9282"}}