Incidence of sodium–glucose cotransporter-2 inhibitor-associated perioperative ketoacidosis in surgical patients: a prospective cohort study

Purpose Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are commonly prescribed anti-diabetic medications with various beneficial effects; however, they have also been associated with ketoacidosis. The aim of this study was to determine the incidence of SGLT2i-associated perioperative ketoacidos...

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Bibliographic Details
Published in:Journal of anesthesia 2024-08, Vol.38 (4), p.464-474
Main Authors: Seki, Hiroyuki, Kuratani, Norifumi, Shiga, Toshiya, Iwasaki, Yudai, Karita, Kanae, Yasuda, Kazuki, Yamamoto, Natsuko, Nakanishi, Yuko, Shigematsu, Kenji, Kobayashi, Kensuke, Saito, Junichi, Kondo, Ichiro, Yaida, Nozomu, Watanabe, Hidenobu, Higashi, Midoriko, Shirasaka, Tetsuro, Doshu-Kajiura, Akira, Edanaga, Mitsutaka, Tanaka, Satoshi, Ikumi, Saori, Ito, Shingo, Okada, Masayuki, Yorozu, Tomoko
Format: Article
Language:English
Subjects:
Adult
Aged
Anesthesiology
Cohort Studies
Critical Care Medicine
Diabetic Ketoacidosis - chemically induced
Diabetic Ketoacidosis - epidemiology
Emergency Medicine
Female
Humans
Incidence
Intensive
Japan - epidemiology
Ketosis - chemically induced
Ketosis - epidemiology
Male
Medicine
Medicine & Public Health
Middle Aged
Original Article
Pain Medicine
Postoperative Complications - diagnosis
Postoperative Complications - epidemiology
Prospective Studies
Sodium-Glucose Transporter 2 Inhibitors - adverse effects
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Summary:Purpose Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are commonly prescribed anti-diabetic medications with various beneficial effects; however, they have also been associated with ketoacidosis. The aim of this study was to determine the incidence of SGLT2i-associated perioperative ketoacidosis (SAPKA) in surgical patients. Methods We conducted a multicenter, prospective cohort study across 16 centers in Japan, enrolling surgical patients with diabetes who were prescribed SGLT2is between January 2021 and August 2022. Patients were monitored until the third postoperative day to screen for SAPKA, defined as urine ketone positivity with a blood pH of 
ISSN:0913-8668
1438-8359
1438-8359
DOI:10.1007/s00540-024-03335-3