{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:16:48Z","timestamp":1777655808048,"version":"3.51.4"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T00:00:00Z","timestamp":1635206400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Sodium\u2013glucose cotransporter 2 inhibitors (SGLT2i) have been associated with diabetic ketoacidosis at the time of colonoscopy. This study aimed to identify factors associated with ketone concentrations in SGLT2i\u2010treated type 2 diabetes compared with non\u2010SGLT2i\u2010treated diabetes, and those with impaired fasting glycaemia (IFG) and normoglycaemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross\u2010sectional, multicentre, observational study June\u2013December 2020 in four Australian tertiary hospitals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Capillary glucose and ketones were measured in people undergoing colonoscopy: 37 SGLT2i\u2010treated and 105 non\u2010SGLT2i\u2010treated type 2 diabetes, 65 IFG and 151 normoglycaemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Body mass index (BMI), age, glucose, fasting duration and where relevant, HbA1c and time since last SGLT2i dose.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In SGLT2i\u2010treated diabetes, BMI (<jats:italic>\u03c1<\/jats:italic>\u2009=\u2009\u22120.43 [95% confidence interval: \u22120.67, \u22120.11]) and duration since last SGLT2i dose (<jats:italic>\u03c1<\/jats:italic>\u2009=\u2009\u22120.33 [\u22120.60, 0.00]) correlated negatively with increasing ketones, but there was no correlation with fasting duration. In non\u2010SGLT2i\u2010treated diabetes, BMI correlated negatively (<jats:italic>\u03c1<\/jats:italic>\u2009=\u2009\u22120.24 [\u22120.42, \u22120.05]) and fasting duration positively (<jats:italic>\u03c1<\/jats:italic>\u2009=\u20090.26 [0.07, 0.43]) with ketones. In IFG participants, only fasting duration correlated with ketones (<jats:italic>\u03c1<\/jats:italic>\u2009=\u20090.28 [0.03, 0.49]). In normoglycaemic participants, there were negative correlations with BMI (<jats:italic>\u03c1<\/jats:italic>\u2009=\u2009\u22120.20 [\u22120.35, \u22120.04]) and fasting glucose (<jats:italic>\u03c1<\/jats:italic>\u2009=\u2009\u22120.31 [\u22120.45, \u22120.15]) and positive correlations with fasting duration (<jats:italic>\u03c1<\/jats:italic>\u2009=\u20090.20 [0.04, 0.35]) and age (<jats:italic>\u03c1<\/jats:italic>\u2009=\u20090.19 [0.03, 0.34]). Multiple regression analysis of the entire cohort showed BMI, age and fasting glucose remained independently associated with ketones, but in SGLT2i\u2010treated participants only BMI remained independently associated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In SGLT2i\u2010treated diabetes, lower BMI was a novel risk factor for higher ketones precolonoscopy. Pending larger confirmatory studies, extra vigilance for ketoacidosis is warranted in these people.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14621","type":"journal-article","created":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T08:11:54Z","timestamp":1635235914000},"page":"549-557","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Body mass index is inversely associated with capillary ketones at the time of colonoscopy: Implications for SGLT2i use"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6280-865X","authenticated-orcid":false,"given":"Peter S.","family":"Hamblin","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Diabetes Western Health Melbourne Victoria Australia"},{"name":"Department of Medicine, Western Health The University of Melbourne Melbourne Victoria 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