{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,8]],"date-time":"2026-11-08T00:30:09Z","timestamp":1794097809701,"version":"4.8.0"},"reference-count":23,"publisher":"American Diabetes Association","issue":"9","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2015,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Sodium\u2013glucose cotransporter 2 (SGLT-2) inhibitors are the most recently approved antihyperglycemic medications. We sought to describe their association with euglycemic diabetic ketoacidosis (euDKA) in hopes that it will enhance recognition of this potentially life-threatening complication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>Cases identified incidentally are described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>We identified 13 episodes of SGLT-2 inhibitor\u2013associated euDKA or ketosis in nine individuals, seven with type 1 diabetes and two with type 2 diabetes, from various practices across the U.S. The absence of significant hyperglycemia in these patients delayed recognition of the emergent nature of the problem by patients and providers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>SGLT-2 inhibitors seem to be associated with euglycemic DKA and ketosis, perhaps as a consequence of their noninsulin-dependent glucose clearance, hyperglucagonemia, and volume depletion. Patients with type 1 or type 2 diabetes who experience nausea, vomiting, or malaise or develop a metabolic acidosis in the setting of SGLT-2 inhibitor therapy should be promptly evaluated for the presence of urine and\/or serum ketones. SGLT-2 inhibitors should only be used with great caution, extensive counseling, and close monitoring in the setting of type 1 diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc15-0843","type":"journal-article","created":{"date-parts":[[2015,6,15]],"date-time":"2015-06-15T21:50:49Z","timestamp":1434405049000},"page":"1687-1693","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":722,"title":["Euglycemic Diabetic Ketoacidosis: A Potential Complication of Treatment With Sodium\u2013Glucose Cotransporter 2 Inhibition"],"prefix":"10.2337","volume":"38","author":[{"given":"Anne L.","family":"Peters","sequence":"first","affiliation":[{"name":"Keck School of Medicine of the University of Southern California, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth O.","family":"Buschur","sequence":"additional","affiliation":[{"name":"The Ohio State University College of Medicine, Columbus, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John B.","family":"Buse","sequence":"additional","affiliation":[{"name":"University of North Carolina School of Medicine, Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pejman","family":"Cohan","sequence":"additional","affiliation":[{"name":"Specialized Endocrine Care Center, Beverly Hills, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie C.","family":"Diner","sequence":"additional","affiliation":[{"name":"University of North Carolina School of Medicine, Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irl B.","family":"Hirsch","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2015,6,15]]},"reference":[{"key":"2022031301081373800_B1","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/S0140-6736(11)60207-9","article-title":"Management of type 2 diabetes: new and future developments in treatment","volume":"378","author":"Tahrani","year":"2011","journal-title":"Lancet"},{"key":"2022031301081373800_B2","doi-asserted-by":"crossref","first-page":"412","DOI":"10.2337\/dc13-2955","article-title":"Exploring the potential of the SGLT2 inhibitor dapagliflozin in type 1 diabetes: a randomized, double-blind, placebo-controlled pilot study","volume":"38","author":"Henry","year":"2015","journal-title":"Diabetes Care"},{"key":"2022031301081373800_B3","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1517\/13543784.2014.909407","article-title":"Empagliflozin, a sodium glucose co-transporter 2 inhibitor, in the treatment of type 1 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FDA warns that SGLT2 inhibitors for diabetes may result in a serious condition of too much acid in the blood. Available from http:\/\/www.fda.gov\/Drugs\/DrugSafety\/ucm446845.htm?source=govdelivery&utm_medium=email&utm_source=govdelivery. 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