RSS-Feed abonnieren
Bitte kopieren Sie die angezeigte URL und fügen sie dann in Ihren RSS-Reader ein.
https://www.thieme-connect.de/rss/thieme/de/10.1055-s-00000146.xml
Diabetes aktuell 2025; 23(04): 175-187
DOI: 10.1055/a-2588-6302
DOI: 10.1055/a-2588-6302
CME-Fortbildung
Ketoazidose bei SGLT2-Hemmer-Therapie

Zusammenfassung
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.
Publikationsverlauf
Artikel online veröffentlicht:
25. Juni 2025
© 2025. Thieme. All rights reserved.
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
-
Literatur
- 1 Deutsche Diabetes Gesellschaft (DDG). et al. S3-Leitlinie Therapie des Typ-1-Diabetes. Version 5.1. 2023. AWMF-Registernummer 057–013, Version 5.1. Zugriff am 12. August 2024 unter: https://register.awmf.org/assets/guidelines/057–013l_S3-Therapie-Typ-1-Diabetes_2023–09_1.pdf
- 2 Chow E, Clement S, Garg R. Euglycemic diabetic ketoacidosis in the era of SGLT-2 inhibitors. BMJ Open Diabetes Res Care 2023; 11: e003666
- 3 Nasa P, Chaudhary S, Shrivastava PK. et al. Euglycemic diabetic ketoacidosis: a missed diagnosis. World J Diabetes 2021; 12: 514-523
- 4 Barski L, Eshkoli T, Brandstaetter E. et al. Euglycemic diabetic ketoacidosis. Eur J Intern Med 2019; 63: 9-14
- 5 Modi A, Agrawal A, Morgan F. Euglycemic diabetic ketoacidosis: a review. Curr Diabetes Rev 2017; 13: 315-321
- 6 Burke KR, Schumacher CA, Harpe SE. sglt2 inhibitors: a systematic review of diabetic ketoacidosis and related risk factors in the primary literature. Pharmacotherapy 2017; 37: 187-194
- 7 Peters AL, Buschur EO, Buse JB. et al. Euglycemic diabetic ketoacidosis: a potential complication of treatment with sodium-Glukose cotransporter 2 inhibition. Diabetes Care 2015; 38: 1687-1693
- 8 Karges B, Rosenbauer J, Holterhus PM. et al. Hospital admission for diabetic ketoacidosis or severe hypoglycemia in 31330 young patients with type 1 diabetes. Eur J Endocrinol 2015; 173: 341-350
- 9 Neu A, Hofer SE, Karges B. et al. Ketoacidosis at diabetes onset is still frequent in children and adolescents: a multicenter analysis of 14,664 patients from 106 institutions. Diabetes Care 2009; 32: 1647-1648
- 10 Bächle C, Kamrath C, Eckert A. et al. Diabetic ketoacidosis at the onset of type I diabetes among children in Germanyanalysis of the prospective DPV registry from 2011 to June 2023. Dtsch Arztebl Int 2024; 121: 272-273
- 11 Natale P, Tunnicliffe DJ, Toyama T. et al. Sodium-Glukose co-transporter protein 2 (SGLT2) inhibitors for people with chronic kidney disease and diabetes. Cochrane Database Syst Rev 2024; 5: CD015588
- 12 Yankah RK, Anku EK, Eligar V. sodium-glukose cotransporter-2 inhibitors and cardiovascular protection among patients with type 2 diabetes mellitus: a systematic review. J Diabetes Res 2024; 2024: 9985836
- 13 van Bommel EJM, Muskiet MHA, Tonneijck L. et al. SGLT2 inhibition in the diabetic kidney-from mechanisms to clinical outcome. Clin J Am Soc Nephrol 2017; 12: 700-710
- 14 Abdul-Ghani M, Del Prato S, Chilton R. et al. SGLT2 inhibitors and cardiovascular risk: lessons learned from the EMPA-REG outcome study. Diabetes Care 2016; 39: 717-725
- 15 Palmiero G, Cesaro A, Vetrano E. et al. Impact of SGLT2 inhibitors on heart failure: from pathophysiology to clinical effects. Int J Mol Sci 2021; 22: 5863
- 16 Bundesinstitut für Arzneimittel und Medizinprodukte. Rote-Hand-Brief zu Dapagliflozin. 25.10.2021 Zugriff am 12. August 2024 unter: https://www.bfarm.de/SharedDocs/Risikoinformationen/Pharmakovigilanz/DE/RHB/2021/rhb-forxiga.html
- 17 Munro JF, Campbell IW, McCuish AC. et al. Euglycaemic diabetic ketoacidosis. Br Med J 1973; 2: 578-580
- 18 Fralick M, Schneeweiss S, Patorno E. risk of diabetic ketoacidosis after initiation of an SGLT2 inhibitor. N Engl J Med 2017; 376: 2300-2302
- 19 European Medicines Agency. Review of diabetes medicines called Sglt2 inhibitors started: risk of diabetic ketoacidosis to be examined. 2015 Zugriff am 12. Juli 2024 unter: https://www.ema.europa.eu/en/documents/referral/sglt2-inhibitorsarticle-20-procedure-review-started_en.pdf
- 20 Wang Y, Desai M, Ryan PB. et al. Incidence of diabetic ketoacidosis among patients with type 2 diabetes mellitus treated with SGLT2 inhibitors and other antihyperglycemic agents. Diabetes Res Clin Pract 2017; 128: 83-90
- 21 Dzaye O, Berning P, Razavi AC. et al. Online searches for SGLT-2 inhibitors and GLP-1 receptor agonists correlate with prescription rates in the United States: an infodemiological study. Front Cardiovasc Med 2022; 9: 936651
- 22 Blau JE, Tella SH, Taylor SI. et al. Ketoacidosis associated with SGLT2 inhibitor treatment: analysis of FAERS data. Diabetes Metab Res Rev 2017; 33
- 23 Bonora BM, Avogaro A, Fadini GP. Sodium-Glukose co-transporter-2 inhibitors and diabetic ketoacidosis: an updated review of the literature. Diabetes Obes Metab 2018; 20: 25-33
- 24 Lucero P, Chapela S. Euglycemic diabetic ketoacidosis in the ICU: 3 case reports and review of literature. Case Rep Crit Care 2018; 2018: 1747850
- 25 Sibai BM, Viteri OA. Diabetic ketoacidosis in pregnancy. Obstet Gynecol 2014; 123: 167-178
- 26 Rajeev SP, Wilding JP. SGLT2 inhibition and ketoacidosis – should we be concerned?. Br J Diabetes Vasc Dis 2015; 15: 155-158
- 27 Ogawa W, Sakaguchi K. Euglycemic diabetic ketoacidosis induced by SGLT2 inhibitors: possible mechanism and contributing factors. J Diabetes Investig 2016; 7: 135-138
- 28 Abdelgani S, Khattab A, Adams J. et al. Distinct mechanisms responsible for the increase in Glukose production and ketone formation caused by empagliflozin in T2Dm patients. Diabetes Care 2023; 46: 978-984
- 29 Al-Hindi B, Mohammed MA, Mangantig E. et al. Prevalence of sodium-Glukose transporter 2 inhibitor-associated diabetic ketoacidosis in real-world data: a systematic review and metaanalysis. J Am Pharm Assoc (2003) 2024; 64: 9-26 .e6
- 30 Yu X, Zhang S, Zhang L. Newer perspectives of mechanisms for euglycemic diabetic ketoacidosis. Int J Endocrinol 2018; 2018: 7074868
- 31 Jenkins D, Close CF, Krentz AJ. et al. Euglycaemic diabetic ketoacidosis: does it exist?. Acta Diabetol 1993; 30: 251-253