Very low carbohydrate diet and SGLT-2-inhibitor: double jeopardy in relation to ketoacidosis

BMJ Case Rep. 2019 Apr 5;12(4):e227516. doi: 10.1136/bcr-2018-227516.

Abstract

Diabetic euglycaemic ketoacidosis is a possible adverse effect of sodium-glucose co-transporter-2 inhibitors (SGLT2i). We report a case in which the combination of SGLT2i and a strict very low-carbohydrate diet led to severe diabetic ketoacidosis in a young Caucasian man with type 2 diabetes.

Keywords: diabetes; diet; drugs: endocrine system; endocrine system; unwanted effects/adverse reaction.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Blood Glucose / drug effects
  • Diabetes Mellitus, Type 2 / metabolism*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetes Mellitus, Type 2 / therapy
  • Diabetic Ketoacidosis / diagnosis*
  • Diabetic Ketoacidosis / etiology
  • Diabetic Ketoacidosis / physiopathology
  • Diabetic Ketoacidosis / therapy
  • Diet, Carbohydrate-Restricted / adverse effects*
  • Diet, Reducing / adverse effects
  • Diet, Reducing / methods*
  • Directive Counseling
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Male
  • Obesity / physiopathology
  • Obesity / therapy*
  • Sodium-Glucose Transporter 2 Inhibitors / adverse effects*
  • Sodium-Glucose Transporter 2 Inhibitors / therapeutic use
  • Treatment Outcome

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Sodium-Glucose Transporter 2 Inhibitors