医学
糖尿病酮症酸中毒
糖尿病
卡格列净
酮症酸中毒
内科学
2型糖尿病
达帕格列嗪
负离子间隙
胰岛素
重症监护医学
作者
Ja Young Jeon,S.-K. Kim,K.-S. Kim,S.O. Song,Jun-Won Yun,Bo Yeon Kim,Chul-Hee Kim,S.O. Park,Soon-Sun Hong,Da Hea Seo,Ji A Seo,Jung Hyun Noh,Dae Jung Kim
标识
DOI:10.1016/j.diabet.2019.01.001
摘要
Abstract Aim This study investigated the clinical characteristics of diabetic ketoacidosis (DKA) and compared the DKA characteristics between patients treated with and without SGLT2 inhibitors. Methods Data were collected from patients aged ≥ 18 years admitted for DKA at nine centres in Korea between September 2014 and April 2017. The electronic medical records of these subjects were retrospectively reviewed. Based on their history of medications taken before admission, subjects were classified as either users or non-users of SGLT2 inhibitors and their clinical characteristics of DKA were compared. Results During the study, the main subtype of DKA episodes (n = 523) was identified as type 2 diabetes (51%). Average hospitalization duration was 11 days, and average intensive care unit (ICU) time was 2.5 days. The in-hospital mortality rate was 3%, but no users of SGLT2 inhibitors died during DKA treatment. In patients taking SGLT2 inhibitors (n = 15), DKA manifested at 124 days, on average, after starting the inhibitors (range: 7–380 days). Also, SGLT2 inhibitors users had significantly lower plasma glucose levels (413 mg/dL) compared with non-users (554 mg/dL), and longer ICU stays (4 vs. 2 days; P = 0.019). Conclusion In this report of recent data on the clinical features of DKA in Korea, patients using SGLT2 inhibitors needed longer treatment in ICUs compared with non-users and had lower levels of blood glucose, whereas DKA associated with SGLT2 inhibitors was rare.
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