Die euglykämische diabetische Ketoazidose (EDKA) ist eine potenziell lebensbedrohliche
Stoffwechselentgleisung bei Menschen mit Diabetes mellitus, die unter Therapie mit
SGLT2-Hemmern/Gliflozinen auftreten kann. Eine entsprechende Therapie muss umgehend
eingeleitet werden.
Abstract
Euglycemic diabetic ketoacidosis represents a special case of diabetic ketoacidosis
characterized by metabolic acidosis and ketonemia, but only mild hyperglycemia (blood
glucose levels <200–300 mg/dl or oder 11,1–16,7 mmol/l).
Oral antidiabetic agents of the SGLT2-inhibitors (sodium-glucose-cotransporter type
2) type have recently gained therapeutic impact due to increasing evidence for their
renal and cardiovascular benefits in addition to antihyperglycemic action. However,
a particularity of SGLT2-inhibitor use is the inherent risk of patients developing
EDKA with a lack of severe ketonuria, which is due to the mechanism of action of these
substances.
The lack of both marked hyperglycemia and ketonuria presents a diagnostic challenge
often leading to delayed diagnosis and therapy in SGLT2-inhibitor-induced EDKA. Therefore,
every physician in patient care has to be aware of this subform of EDKA in order to
prompt diagnostic workup and immediate therapy in patients at risk. Moreover, patients
on SGLT2-inhibitor therapy need appropriate education concerning the specific risks
of this medication in order to prevent further episodes of EDKA.
Schlüsselwörter
Diabetes mellitus - Ketoazidose - euglykämisch - SGLT2-Hemmer
Keywords
diabetes mellitus - ketoacidosis - euglycemic - SGLT2 inhibitor
