管理服用SGLT2抑制剂的住院患者:降低血糖型糖尿病酮症酸中毒的风险

IF 2.4 Q3 ENDOCRINOLOGY & METABOLISM Diabetology Pub Date : 2023-02-21 DOI:10.3390/diabetology4010010
Julia Selwyn, Ariana R. Pichardo-Lowden
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引用次数: 3

摘要

钠-葡萄糖共转运蛋白-2 (SGLT2)抑制剂不仅是2型糖尿病(T2DM)的重要治疗药物,也是心脏病和肾脏疾病的重要治疗药物。随着这些药物被接受,接受它们的住院患者数量可能会增加。在临床试验中,SGLT2抑制剂被注意到具有糖尿病酮症酸中毒(DKA)的潜在风险,特别是血糖水平相对正常的DKA,“血糖正常的DKA”。与与SGLT2抑制剂无关的DKA类似,这些事件中的大多数似乎与急性疾病或患者药物或自我管理环境的其他变化有关。这使得医院提供者需要制定预防住院患者DKA的策略,并指导监测和治疗血糖正常性DKA。我们对这一现象的综合经验使我们对这一问题有了深入的了解,并通过加强患者教育、住院监护和早期治疗血糖正常的DKA来改善患者护理所需的知识。
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Managing Hospitalized Patients Taking SGLT2 Inhibitors: Reducing the Risk of Euglycemic Diabetic Ketoacidosis
Sodium-glucose cotransporter-2 (SGLT2) inhibitors are emerging as an important therapy not only for type 2 diabetes (T2DM), but also for heart disease and kidney disease. As these medicines gain acceptance, the number of hospitalized patients receiving them is likely to rise. During clinical trials, SGLT2 inhibitors were noted to have a potential risk for diabetic ketoacidosis (DKA), particularly DKA with relatively normal blood glucose levels, ‘euglycemic DKA’. Similar to DKA that is not associated with SGLT2 inhibitors, most of these events seem to be related to acute illnesses or other changes in a patient’s medications or self-management circumstances. This creates a need among hospital providers to create strategies to prevent DKA in their hospitalized patient and guidance on monitoring and treating euglycemic DKA. Our combined experience concerning this phenomenon has given a great deal of insight into this problem and the knowledge needed to improve patient care, by augmenting patient education, inpatient surveillance, and early treatment for euglycemic DKA.
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