[Ketogenic diet as a trigger for diabetic euglycaemic ketoacidosis in a patient under treatment with iSGLT2]

Hipertens Riesgo Vasc. 2020 Jan-Mar;37(1):39-41. doi: 10.1016/j.hipert.2019.09.003. Epub 2019 Nov 14.
[Article in Spanish]

Abstract

Euglycaemic diabetic ketoacidosis is a possible adverse effect of selective sodium-glucose cotransporter inhibitors 2 (isGLT2) in patients with diabetes. However, the main scientific societies have recently recommended low or very low carbohydrate diets for the treatment of diabetes, relating the latter with the onset of ketosis. The combination of treatment with these drugs and following this type of diet can be dangerous. We present the case of a 64-year-old patient, suffering from LADA type diabetes, under usual treatment with intensive insulin therapy in 4 doses, who a few days after starting empagliflocin and a very low carbohydrate diet presented severe euglycaemic ketoacidotic decompensation.

Keywords: Cetoacidosis; Diabetes mellitus de tipo 1; Dieta cetogénica; Empagliflocina; Empagliflozin; Euglucémica; Isglt2; Ketoacidosis; Ketodiet; Type 1 diabetes; Very low carb diet; iSGLT2.

Publication types

  • Case Reports

MeSH terms

  • Benzhydryl Compounds / administration & dosage
  • Benzhydryl Compounds / adverse effects
  • Diabetic Ketoacidosis / etiology*
  • Diet, Ketogenic / adverse effects*
  • Glucosides / administration & dosage
  • Glucosides / adverse effects
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / adverse effects*
  • Insulin / administration & dosage
  • Insulin / adverse effects
  • Latent Autoimmune Diabetes in Adults / complications*
  • Latent Autoimmune Diabetes in Adults / therapy
  • Male
  • Middle Aged
  • Sodium-Glucose Transporter 2 Inhibitors / administration & dosage
  • Sodium-Glucose Transporter 2 Inhibitors / adverse effects

Substances

  • Benzhydryl Compounds
  • Glucosides
  • Hypoglycemic Agents
  • Insulin
  • Sodium-Glucose Transporter 2 Inhibitors
  • empagliflozin