LDE: Popular Diabetes Drugs Linked to Risk of a Dangerous Complication in Certain Patients

Among patients with type 2 diabetes, higher blood glucose levels, low body weight, and a previous episode of ketoacidosis are associated with a higher risk of developing this potentially dangerous complication while taking SGLT2 inhibitors. The risk persists throughout the entire course of treatment, according to a study by researchers at Karolinska Institutet published in The Lancet Diabetes & Endocrinology.

SGLT2 inhibitors are used to treat type 2 diabetes and can also reduce the risk of cardiovascular and kidney disease. However, in some patients, they increase the likelihood of diabetic ketoacidosis (DKA)—a rare but serious condition in which the body begins producing excessive amounts of ketones due to insufficient insulin. This disrupts the body’s acid-base balance and can be life-threatening in severe cases.

The researchers analyzed data from national medical registries in Sweden, Denmark, and Norway. The study included more than 280,000 patients with type 2 diabetes who were receiving SGLT2 inhibitors.

The highest risk of ketoacidosis was observed among patients who had previously experienced the condition, had high blood glucose levels, low body weight, or signs of inadequate nutrition. A history of hypoglycemic episodes was also associated with an increased risk.

Ketoacidosis most often occurred in the setting of an infection, which was the most common triggering or accompanying factor. Patients who developed the complication were also more likely to experience other acute conditions, including impaired kidney function, stroke, and the need for major surgery.

Previous studies have primarily assessed the risk of ketoacidosis during the first few months after treatment begins. The new study showed that although the risk is indeed highest at the start of therapy, it remains elevated throughout the entire period of treatment.

“Our findings do not mean that this type of treatment should be abandoned. The main goal is to better identify patients at high risk and use these medications more safely,” said Peter Ueda, associate professor at Karolinska Institutet.

The researchers hope the findings will help doctors make more informed decisions when prescribing these medications and help patients better understand situations in which they may need to temporarily stop taking them, such as during an acute illness or before surgery.

As a next step, the scientists plan to study in greater detail patients who develop ketoacidosis while taking SGLT2 inhibitors, as well as other rare but serious adverse effects associated with modern diabetes medications.

Follow NEWS.am Medicine on Facebook and Twitter