{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T02:00:54Z","timestamp":1784599254834,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100015539","name":"Australian Government","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015539","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The use and safety of sodium\u2010glucose co\u2010transporter 2 inhibitors (SGLT2i) in hospital are controversial due to the risk of ketoacidosis. We aimed to describe rates of ketosis, ketoacidosis, and acidosis in patients with type 2 diabetes treated with in\u2010hospital SGLT2i use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>Single\u2010centre retrospective cohort study of adult patients with type 2 diabetes admitted for &gt;24\u2009h. Rates of ketone testing, ketone levels, ketosis precipitants, and ketoacidosis and acidosis frequency were determined from examination of electronic medical records. Outcomes were described relative to the first dose of SGLT2i in hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 1511 patients who received SGLT2i at any stage of admission; of these, 777 (51.4%) had ketone levels checked. Peak ketone levels after the first dose of SGLT2i were &gt;1\u2009mmol\/L in 12.6% and &gt;3\u2009mmol\/L in 2.8%. Eleven out of 12 patients with ketones &gt;3\u2009mmol\/L post\u2010SGLT2i had ketosis in the setting of a procedure or surgery, sepsis, reduced oral intake, or critical illness. No patient admitted with heart failure had a ketone level &gt;2\u2009mmol\/L. Biochemical ketoacidosis occurred in 1.7% of SGLT2i users pre\u2010first dose of SGLT2i and 0.7% after the first dose. Acidosis (irrespective of ketone levels) occurred in 16.8% before the first dose of SGLT2i and 5.5% after the first dose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Ketosis following inpatient SGLT2i administration was infrequent and generally occurred in the setting of known precipitants. These results suggest that, in hospitalized patients selected by clinicians to receive SGLT2i, clinically significant ketone accumulation is low in prevalence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70029","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T10:24:53Z","timestamp":1754907893000},"page":"6367-6374","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Ketosis and ketoacidosis in hospitalized patients receiving\n                    <scp>SGLT2<\/scp>\n                    inhibitor therapy"],"prefix":"10.1111","volume":"27","author":[{"given":"Frank M.","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Endocrinology Austin Hospital  Melbourne Australia"},{"name":"Department of Medicine, Austin Health, Melbourne Medical School The University of Melbourne  Melbourne Australia"},{"name":"Australian Centre for Accelerating Diabetes Innovations, Melbourne Medical School The University of Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kartik","family":"Kishore","sequence":"additional","affiliation":[{"name":"Australian Centre for Accelerating Diabetes Innovations, Melbourne Medical School The University of Melbourne  Melbourne Australia"},{"name":"Data Analytics Research and Evaluation Centre Austin Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinesh","family":"Pandey","sequence":"additional","affiliation":[{"name":"Data Analytics Research and Evaluation Centre Austin Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossein","family":"Jahanabadi","sequence":"additional","affiliation":[{"name":"Data Analytics Research and Evaluation Centre Austin Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meg","family":"Stevens","sequence":"additional","affiliation":[{"name":"Data Analytics Research and Evaluation Centre Austin Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashani","family":"Lecamwasam","sequence":"additional","affiliation":[{"name":"Department of Medicine, Austin Health, Melbourne Medical School The University of Melbourne  Melbourne Australia"},{"name":"Department of Nephrology Northern Health  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rinaldo","family":"Bellomo","sequence":"additional","affiliation":[{"name":"Data Analytics Research and Evaluation Centre Austin Hospital  Melbourne Victoria Australia"},{"name":"Australian and New Zealand Intensive Care Research Centre (ANZIC\u2010RC), School of Public Health and Preventive Medicine Monash University  Melbourne Australia"},{"name":"Department of Critical Care, Melbourne Medical School University of Melbourne, Austin Hospital  Melbourne Australia"},{"name":"Department of Intensive Care Austin Hospital  Melbourne Australia"},{"name":"Department of Intensive Care Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonid","family":"Churilov","sequence":"additional","affiliation":[{"name":"Australian Centre for Accelerating Diabetes Innovations, Melbourne Medical School The University of Melbourne  Melbourne Australia"},{"name":"Department of Medicine (RMH), Melbourne Medical School The University of Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2372-395X","authenticated-orcid":false,"given":"Elif I.","family":"Ekinci","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Austin Hospital  Melbourne Australia"},{"name":"Department of Medicine, Austin Health, Melbourne Medical School The University of Melbourne  Melbourne Australia"},{"name":"Australian Centre for Accelerating Diabetes Innovations, Melbourne Medical School The University of Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-024-00836-y"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14805"},{"issue":"1","key":"e_1_2_10_4_1","first-page":"S321","article-title":"16. 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