Diabetic ketoacidosis has been reported in patients with type 2 diabetes on a combination of a GLP-1 receptor agonist and insulin who had doses of concomitant insulin rapidly reduced or discontinued. GLP-1 receptor agonists are not substitutes for insulin, and any reduction of insulin should be done in a stepwise manner with careful glucose self-monitoring (Medicines and Healthcare products Regulatory Agency)
Diabetes News
Tag: Ketoacidosis
Diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome: review of acute decompensated diabetes in adult patients
This review covers recommendations for acute management of diabetic ketoacidosis and HHS, the complications associated with these disorders, and methods for preventing recurrence. It also discusses why many patients who present with these disorders are at high risk for hospital readmissions, early morbidity, and mortality well beyond the acute presentation (BMJ)
International Consensus on Risk Management of Diabetic Ketoacidosis in Patients with Type 1 Diabetes Treated with Sodium-Glucose Cotransporter (SGLT) Inhibitors
This consensus report reviews current data regarding SGLT- inhibitor use and provides recommendations to enhance the safety of SGLT-inhibitors in people with type 1 diabetes (Diabetes Care)
The incidence of diabetic ketoacidosis during Ramadan fasting: a 10-year single-centre retrospective study
The present study confirmed that DKA admissions during Ramadan were not significantly higher than the average monthly admissions over ten years. Seasonality trends were not related to Ramadan (Diabetes Research and Clinical Practice)
Trends in Hospital Admission for Diabetic Ketoacidosis in Adults With Type 1 and Type 2 Diabetes in England, 1998–2013: A Retrospective Cohort Study
In the previous 2 decades in England, hospitalization for DKA increased in adults with T1DM and in those with T2DM, and associated health care performance did not improve except decreased length of hospital stay (Diabetes Care)
Effects of Sotagliflozin Added to Insulin in Patients with Type 1 Diabetes
Among patients with type 1 diabetes who were receiving insulin, the proportion of patients who achieved a glycated hemoglobin level lower than 7.0% with no severe hypoglycemia or diabetic ketoacidosis was larger in the group that received sotagliflozin than in the placebo group. However, the rate of diabetic ketoacidosis was higher in the sotagliflozin group (NEJM)
Incidence and prevalence of diabetic ketoacidosis (DKA) among adults with type 1 diabetes mellitus (T1D): a systematic literature review
To our knowledge, this is the first SLR on the epidemiology of DKA in T1D adults. Despite an increasing prevalence of T1D in recent years, DKA in adults has been poorly characterised. In an era when the benefit–risk profiles of new antidiabetic therapies are being evaluated, including the potential risk of DKA, there is a clear need to better elucidate the expected rate of DKA among T1D adults. (BMJ)
The cost of treating diabetic ketoacidosis in the UK: a national survey of hospital resource use
Despite relatively short stays in hospital, costs for managing episodes of diabetic ketoacidosis in adults were relatively high. Assumptions made in the calculations did not consider prolonged hospital stay due to comorbidities or costs incurred as a loss of productivity. Therefore, the actual costs to the healthcare system and society in general are likely to be substantially higher (Diabetic Medicine)
Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes Predicts Poor Long-term Glycemic Control
DKA at diagnosis of type 1 diabetes in children predicts poor long-term glycemic control, independent of demographic and socioeconomic factors (Diabetes Care)
Risk of Diabetic Ketoacidosis after Initiation of an SGLT2 Inhibitor
Shortly after initiation, SGLT2 inhibitors were associated with approximately twice the risk of diabetic ketoacidosis as were DPP4 inhibitors, although cases of diabetic ketoacidosis leading to hospitalization were infrequent (NEJM)
SGLT2-I in the Hospital Setting: Diabetic Ketoacidosis and Other Benefits and Concerns
We cautiously suggest the use of SGLT2 inhibitors in the hospital. However, these must be used judiciously and the practitioner must be aware of euglycemic diabetic ketoacidosis and its risk factors in this population (Current Diabetes Reports)
Effects of SGLT-2 inhibitors on diabetic ketoacidosis: A meta-analysis of randomised controlled trials
The results of clinical trials summarized in the present meta-analysis reassure us that, when the drug is properly prescribed, the risk of DKA is negligible (Diabetes Research and Clinical Practice)
Treatment of Diabetic Ketoacidosis (DKA)/Hyperglycemic Hyperosmolar State (HHS): Novel Advances in the Management of Hyperglycemic Crises (UK Versus USA)
There is considerable overlap but important differences between the UK and USA guidelines for the management of DKA and HHS. Further research needs to be done to delineate a unifying diagnostic and treatment protocol (Current Diabetes Reports)
Self-reported regular alcohol consumption in adolescents and emerging adults with type 1 diabetes
A neglected risk factor for diabetic ketoacidosis? Multicenter analysis of 29 630 patients from the DPV registry (Pediatric Diabetes)
Risk of death following admission to a UK hospital with diabetic ketoacidosis
Recurrent DKA is associated with substantial mortality, particularly among young, socially disadvantaged adults with very high HbA1c levels (Diabetologia)
Distinct clinical characteristics and therapeutic modalities for diabetic ketoacidosis in type 1 and type 2 diabetes mellitus
DKA patients with type 2 diabetes required management with a modified treatment protocol to resolve their profound hyperglycemia and dehydration compared with those with type 1 diabetes (Journal of Diabetes and Its Complications)
Examining the “Killer K” of Diabetic Ketoacidosis at a Tertiary Care Hospital: An Exploratory Study
Hypokalemia occurs frequently during acute DKA management and is often preventable. Our findings suggest that interventions targeted at enhancing awareness of guidelines may reduce hypokalemia rates (Canadian Journal of Diabetes)
EMA confirms recommendations to minimise ketoacidosis risk with SGLT2 inhibitors for diabetes
Healthcare professionals should be aware of possible atypical cases (European Medicines Agency)
Subcutaneous rapid-acting insulin analogues for diabetic ketoacidosis
Our review, which provided mainly data on adults, suggests on the basis of mostly low- to very low-quality evidence that there are neither advantages nor disadvantages when comparing the effects of subcutaneous rapid-acting insulin analogues versus intravenous regular insulin for treating mild or moderate DKA (Cochrane)
SGLT2 inhibitors: PRAC makes recommendations to minimise risk of diabetic ketoacidosis
EMA’s Pharmacovigilance Risk Assessment Committee (PRAC) has finalised a review of SGLT2 inhibitors (a class of type 2 diabetes medicines) and has made recommendations to minimise the risk of diabetic ketoacidosis (EMA)
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