Association of sodium glucose co-transporter-2 inhibitors with risk of diabetic ketoacidosis among hospitalized patients: A multicentre cohort study

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM Journal of diabetes and its complications Pub Date : 2024-07-29 DOI:10.1016/j.jdiacomp.2024.108827

Shohinee Sarma , Benazir Hodzic-Santor , Afsaneh Raissi , Michael Colacci , Amol A. Verma , Fahad Razak , Mats C. Højbjerg Lassen , Michael Fralick

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Abstract

Introduction

Sodium glucose co-transporter-2 inhibitors (SGLT-2i) are increasingly being used among hospitalized patients. Our objective was to assess the risk of diabetic ketoacidosis (DKA) among hospitalized patients receiving an SGLT-2i.

Research design and methods

We conducted a multicentre cohort study of patients hospitalized at 19 hospitals. We included patients over 18 years of age who received an SGLT-2i or a dipeptidyl peptidase-4 inhibitor (DPP-4i) in hospital. The primary outcome was the risk of DKA during their hospitalization.

Results

61,517 patients received a DPP-4i and 11,061 received an SGLT-2i. The risk of inpatient DKA was 0.07 % (N = 41 events) among adults who received a DPP-4i and 0.18 % (N = 20 events) among adults who received an SGLT-2i; adjusted odds ratio of 3.30 (95 % CI: 1.85–5.72).

Conclusions

In hospitalized patients, the absolute risk of DKA was 0.2 %, which corresponded to a three-fold higher relative risk.

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钠葡萄糖共转运体-2 抑制剂与住院患者糖尿病酮症酸中毒风险的关系：一项多中心队列研究。

简介：住院患者越来越多地使用钠葡萄糖共转运体-2抑制剂（SGLT-2i）。我们的目的是评估接受 SGLT-2i 治疗的住院患者发生糖尿病酮症酸中毒（DKA）的风险：我们对 19 家医院的住院患者进行了一项多中心队列研究。我们纳入了在医院接受 SGLT-2i 或二肽基肽酶-4 抑制剂 (DPP-4i) 治疗的 18 岁以上患者。主要结果是住院期间发生 DKA 的风险：61,517名患者接受了DPP-4i治疗，11,061名患者接受了SGLT-2i治疗。接受DPP-4i治疗的成人患者住院期间发生DKA的风险为0.07%（N = 41例），接受SGLT-2i治疗的成人患者住院期间发生DKA的风险为0.18%（N = 20例）；调整后的几率比为3.30（95 % CI：1.85-5.72）：住院患者发生 DKA 的绝对风险为 0.2%，相对风险高出三倍。

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来源期刊

Journal of diabetes and its complications 医学-内分泌学与代谢

CiteScore

5.90

自引率

3.30%

发文量

153

审稿时长

16 days

期刊介绍： Journal of Diabetes and Its Complications (JDC) is a journal for health care practitioners and researchers, that publishes original research about the pathogenesis, diagnosis and management of diabetes mellitus and its complications. JDC also publishes articles on physiological and molecular aspects of glucose homeostasis. The primary purpose of JDC is to act as a source of information usable by diabetes practitioners and researchers to increase their knowledge about mechanisms of diabetes and complications development, and promote better management of people with diabetes who are at risk for those complications. Manuscripts submitted to JDC can report any aspect of basic, translational or clinical research as well as epidemiology. Topics can range broadly from early prediabetes to late-stage complicated diabetes. Topics relevant to basic/translational reports include pancreatic islet dysfunction and insulin resistance, altered adipose tissue function in diabetes, altered neuronal control of glucose homeostasis and mechanisms of drug action. Topics relevant to diabetic complications include diabetic retinopathy, neuropathy and nephropathy; peripheral vascular disease and coronary heart disease; gastrointestinal disorders, renal failure and impotence; and hypertension and hyperlipidemia.