Peri-colonoscopy Implications of Sodium-Glucose Cotransporter-2 Inhibitor Therapy: A Mini-review of Available Evidence

Venkatesan Thiruvenkatarajan; Joshua M Inglis; Emily Meyer; Mahesh M Umapathysivam; Nagesh Nanjappa; Roelof Van Wijk; David Jesudason

doi:10.1016/j.jcjd.2022.12.003

Peri-colonoscopy Implications of Sodium-Glucose Cotransporter-2 Inhibitor Therapy: A Mini-review of Available Evidence

Can J Diabetes. 2023 Apr;47(3):287-291. doi: 10.1016/j.jcjd.2022.12.003. Epub 2022 Dec 24.

Authors

Venkatesan Thiruvenkatarajan¹, Joshua M Inglis², Emily Meyer³, Mahesh M Umapathysivam³, Nagesh Nanjappa⁴, Roelof Van Wijk⁴, David Jesudason³

Affiliations

¹ Department of Anaesthesia, Queen Elizabeth Hospital, South Australia, Australia; Discipline of Acute Care Medicine, University of Adelaide, South Australia, Australia; Basil Hetzel Institute, South Australia, Australia. Electronic address: venkatesan.thiruvenkatarajan@sa.gov.au.
² Department of Endocrinology and Diabetes, Queen Elizabeth Hospital, South Australia, Australia; School of Medicine, University of Adelaide, South Australia, Australia; College of Medicine and Public Health, Flinders University, South Australia, Australia.
³ Department of Endocrinology and Diabetes, Queen Elizabeth Hospital, South Australia, Australia; School of Medicine, University of Adelaide, South Australia, Australia.
⁴ Department of Anaesthesia, Queen Elizabeth Hospital, South Australia, Australia; Discipline of Acute Care Medicine, University of Adelaide, South Australia, Australia; Basil Hetzel Institute, South Australia, Australia.

PMID: 36739255
DOI: 10.1016/j.jcjd.2022.12.003

Abstract

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are a class of oral glucose-lowering agents commonly used for the treatment of type 2 diabetes. With increased use, there has been an increase in the incidence of the rare but life-threatening complication of euglycemic diabetic ketoacidosis. A common but underappreciated precipitant is colonoscopy. In this work, we outline the pathophysiology of the interaction between colonoscopy and SGLT2i use, the evidence regarding SGLT2i use in the periprocedural setting and Australian Diabetes Society guidelines.

Keywords: SGLT2i; acidocétose; colonoscopy; coloscopie; diabetes; diabète; iSGLT2; ketoacidosis; peri-colonoscopy; péricoloscopie; review; revue.

Publication types

Review

MeSH terms

Australia
Blood Glucose / analysis
Cathartics / administration & dosage
Cathartics / adverse effects
Colonoscopy* / adverse effects
Diabetes Mellitus, Type 2* / complications
Diabetes Mellitus, Type 2* / drug therapy
Diabetic Ketoacidosis* / blood
Diabetic Ketoacidosis* / etiology
Diabetic Ketoacidosis* / physiopathology
Diabetic Ketoacidosis* / prevention & control
Glucose
Humans
Hypoglycemic Agents* / adverse effects
Hypoglycemic Agents* / therapeutic use
Ketones / metabolism
Sodium
Sodium-Glucose Transporter 2 Inhibitors* / adverse effects
Sodium-Glucose Transporter 2 Inhibitors* / therapeutic use

Substances

Blood Glucose
Glucose
Hypoglycemic Agents
Sodium
Sodium-Glucose Transporter 2 Inhibitors
Cathartics
Ketones