Main Article Content
Abstract
RÉSUMÉ
Les inhibiteurs des transporteurs couplés sodium-glucose de type 2 représentent l’une des molécules de protection cardiovasculaire dans le traitement du diabète sucré. L’un de leurs effets secondaires est l’acidocétose. Nous rapportons les cas d’acidocétose recensés au Centre Hospitalier Sud Francilien chez des patients diabétiques traités par dapagliflozine. Nous rapportons l’observation médicale de 3 patients sur 5 mois. Etaient retrouvées une acidose métabolique avec une hyperglycémie. Les facteurs déclenchants étaient une infection pour deux patients et une déshydratation avec réduction des apports caloriques pour le 3e. L’éducation du patient et le dépistage précoce sont les clés de la prévention
Abstract
Type 2 sodium-glucose transporter inhibitors are one of the main cardiovascular protective molecules in the treatment of diabetes mellitus. One of their main adverse effects is ketoacidosis. We aimed to describe cases of ketoacidosis in diabetic patients treated with dapagliflozin at the Centre Hospitalier Sud Francilien. We identified 3 patients over 5-month. Were found a metabolic acidosis and hyperglycemia. The triggering factors were an infection for two patients and dehydration with reduced caloric intake for the third. Ketoacidosis in diabetic patients treated by i-SGLT2 is a life-threatening complication. Patient education and early detection are the keys of prevention.
Abréviations : i-SGLT2 (inhibiteurs des transporteurs couplés sodium-glucose de type 2), FDA (Food and Drug Administration), SAMU (Service d’Aide Médicale Urgente), DFG (Débit de Filtration Glomérulaire), DKA (Diabetes Keto Acidosis), min (minutes), FEVG (Fraction d’Ejection du Ventricule Gauche), SARM (Staphylococcus Aureus Résistant à la Méticilline)
Keywords
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
- Rhys W, Colagiuri S, Almutairi R, Basit A. IDF Diabetes Atlas,ninth edition [Internet]. International Diabetes Federation; 2019. Disponible sur: www.diabetesatlas.org
- U.S. Department of Health and Human Services, Food and Drug Administration, Center for Drug Evalua8on and Research Guidance for Industry. Diabetes Mellitus:Evaluating Cardiovascular Risk in New Antidiabetic Therapies to Treat Type 2 Diabetes . FDA Maryland; 2008.
- Zinman B, Wanner C, Lachin J. Empagliflozin, cardiovascular outcomes, and mortality in Type 2 diabetes. N Engl J Med. 2015;373:2117‑28.
- Wiviott S, Raz L, Bonaca M, Mosenzon O. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2019;380:347‑57.
- Neal B, Perkovic V, Mahaffey K, de Zeeuw D. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. N Engl J Med. 2017;377:644‑57.
- Henry R, Thakkar P, Tong C, Polidori D, Alba M. Efficacy and safety of canagliflozin, a sodium-glucose cotransporter 2 inhibitor, as add-on to insulin in patients with type I diabetes. Diabetes Care. 2015;38:2258‑65.
- Erondu N, Desai M, Ways K, Meininger G. Diabetic ketoacidosis and related events in the canagliflozin type 2 diabetes clinical program. Diabetes Care. 2015;38:1680‑6.
- Diaz-Ramos A, Wesley E, Diego M. Euglycemic diabetic ketoacidosis associated with sodium-glucose cotransporter-2 inhibitor use: a case report and review of the literature. International Journal of Emergency Medicine [Internet]. 2019;12(27). Disponible sur: https://doi.org/10.1186/s12245-019-0240-0
- Peters A, Buschur E, Buse J, Cohan P. Euglycemic Diabetic Ketoacidosis: A Potential Complication of Treatment With Sodium-Glucose Cotransporter 2 Inhibition. Diabetes Care. 2015;38:1687‑93.
- Keller U, Schnell H, Sonnenberg G, Gerber P. Role of glucagon in enhancing ketone body production in ketotic diabetic man. Diabetes. 1983;32:387‑91.
- Ferrannini E, Muscelli E, Frascerra S, Baldi S. Metabolic response to sodium-glucose cotransporter 2 inhibition in type 2 diabetic patients. J Clin Invest. 2014;124:499‑508.
- Gelaye A, Haidar A, Kassab C, Kazmi S. Severe ketoacidosis associated with canagliflozin (Invokana): a safety concern. Case Rep Crit Care. 2016;
- FDA Drug Safety Communication. FDA revises labels of SGLT2 inhibitors for diabetes to include warnings about too much acid in the blood and serious urinary tract infections [Internet]. 2016. Disponible sur: http://www.fda.gov/Drugs/DrugSafety/ucm475463.htm.
- Meyer EJ, Gabb G, Jesudason D. SGLT2 Inhibitor–Associated Euglycemic Diabetic Ketoacidosis: A South Australian Clinical Case Series and Australian Spontaneous Adverse Event Notifications. Diabetes Care. avr 2018;41(4):e47‑9.
- Dizon S, Keely E, Malcom J, Arnaout A. Insights into the recognition and management of SGLT2-inhibitor-associated ketoacidosis: it’s not just euglycemic diabetic ketoacidosis. Can J Diabetes. 2017;41:499‑503.
- Fadini G, Bonora B, Avogaro A. SGLT2 inhibitors and diabetic ketoacidosis: data from the FDA adverse event reporting system. Diabetologia. 2017;60:1385‑9.
- Carlier A, Amouyal C. Cétoacidose diabétique. EMC-Endocrinologie-Nutrition. oct 2018;15(4):1‑10.
- Siriman A, Mahamadoun C, Moustaph I, Abdoulhamidou A, Diop M, Seidou A, et al. Complications Métaboliques Aiguës du Diabète au Service d’Accueil des Urgences du CHU Gabriel Touré: Aspects Epidémiocliniques et Pronostiques. Health Sci Dis [Internet]. 29 juin 2022 [cité 3 avr 2023];23(7). Disponible sur: https://hsd-fmsb.org/index.php/hsd/article/view/3759
- Turner J, Tahmina B, Smalligan R. Canagliflozin-Induced Diabetic Ketoacidosis: Case Report and sReview of the Literature. Journal of Investigative Medicine High Impact Case Reports. 2016;1‑3.
References
Rhys W, Colagiuri S, Almutairi R, Basit A. IDF Diabetes Atlas,ninth edition [Internet]. International Diabetes Federation; 2019. Disponible sur: www.diabetesatlas.org
U.S. Department of Health and Human Services, Food and Drug Administration, Center for Drug Evalua8on and Research Guidance for Industry. Diabetes Mellitus:Evaluating Cardiovascular Risk in New Antidiabetic Therapies to Treat Type 2 Diabetes . FDA Maryland; 2008.
Zinman B, Wanner C, Lachin J. Empagliflozin, cardiovascular outcomes, and mortality in Type 2 diabetes. N Engl J Med. 2015;373:2117‑28.
Wiviott S, Raz L, Bonaca M, Mosenzon O. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2019;380:347‑57.
Neal B, Perkovic V, Mahaffey K, de Zeeuw D. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. N Engl J Med. 2017;377:644‑57.
Henry R, Thakkar P, Tong C, Polidori D, Alba M. Efficacy and safety of canagliflozin, a sodium-glucose cotransporter 2 inhibitor, as add-on to insulin in patients with type I diabetes. Diabetes Care. 2015;38:2258‑65.
Erondu N, Desai M, Ways K, Meininger G. Diabetic ketoacidosis and related events in the canagliflozin type 2 diabetes clinical program. Diabetes Care. 2015;38:1680‑6.
Diaz-Ramos A, Wesley E, Diego M. Euglycemic diabetic ketoacidosis associated with sodium-glucose cotransporter-2 inhibitor use: a case report and review of the literature. International Journal of Emergency Medicine [Internet]. 2019;12(27). Disponible sur: https://doi.org/10.1186/s12245-019-0240-0
Peters A, Buschur E, Buse J, Cohan P. Euglycemic Diabetic Ketoacidosis: A Potential Complication of Treatment With Sodium-Glucose Cotransporter 2 Inhibition. Diabetes Care. 2015;38:1687‑93.
Keller U, Schnell H, Sonnenberg G, Gerber P. Role of glucagon in enhancing ketone body production in ketotic diabetic man. Diabetes. 1983;32:387‑91.
Ferrannini E, Muscelli E, Frascerra S, Baldi S. Metabolic response to sodium-glucose cotransporter 2 inhibition in type 2 diabetic patients. J Clin Invest. 2014;124:499‑508.
Gelaye A, Haidar A, Kassab C, Kazmi S. Severe ketoacidosis associated with canagliflozin (Invokana): a safety concern. Case Rep Crit Care. 2016;
FDA Drug Safety Communication. FDA revises labels of SGLT2 inhibitors for diabetes to include warnings about too much acid in the blood and serious urinary tract infections [Internet]. 2016. Disponible sur: http://www.fda.gov/Drugs/DrugSafety/ucm475463.htm.
Meyer EJ, Gabb G, Jesudason D. SGLT2 Inhibitor–Associated Euglycemic Diabetic Ketoacidosis: A South Australian Clinical Case Series and Australian Spontaneous Adverse Event Notifications. Diabetes Care. avr 2018;41(4):e47‑9.
Dizon S, Keely E, Malcom J, Arnaout A. Insights into the recognition and management of SGLT2-inhibitor-associated ketoacidosis: it’s not just euglycemic diabetic ketoacidosis. Can J Diabetes. 2017;41:499‑503.
Fadini G, Bonora B, Avogaro A. SGLT2 inhibitors and diabetic ketoacidosis: data from the FDA adverse event reporting system. Diabetologia. 2017;60:1385‑9.
Carlier A, Amouyal C. Cétoacidose diabétique. EMC-Endocrinologie-Nutrition. oct 2018;15(4):1‑10.
Siriman A, Mahamadoun C, Moustaph I, Abdoulhamidou A, Diop M, Seidou A, et al. Complications Métaboliques Aiguës du Diabète au Service d’Accueil des Urgences du CHU Gabriel Touré: Aspects Epidémiocliniques et Pronostiques. Health Sci Dis [Internet]. 29 juin 2022 [cité 3 avr 2023];23(7). Disponible sur: https://hsd-fmsb.org/index.php/hsd/article/view/3759
Turner J, Tahmina B, Smalligan R. Canagliflozin-Induced Diabetic Ketoacidosis: Case Report and sReview of the Literature. Journal of Investigative Medicine High Impact Case Reports. 2016;1‑3.