|
The
Prevention of Diabetic Ketoacidosis
in Patients with Type 2 Diabetes
on Sodium-Glucose Transport Protein
2 Inhibitors
Sara Elsheikh Ahmedana 1, Musa Basheer
Mansour 2, Amr Musa Basheer 3
(1) Co-author Musa Basheer Mansour,
MBBS, MD, MSc, Dip, Consultant at
PHCC, Primary Health Care Corporation,
Umm Ghuwailina Health Center- Doha-Qata
(2) Co-author Amr Musa Basheer,
Medical Student at The Royal College
of Surgeons in Ireland – Medical
University of Bahrain, Adliya, Bahrain.
(3) Corresponding author, Sara Elsheikh
Ahmedana, MBBS, MD, MSc, Dip, Consultant
at PHCC, Primary Health Care Corporation,
Abu Baker Al-Siddiq Health Center-
Doha-Qatar
Corresponding author:
Sara Elsheikh Ahmedana, MBBS, MD,
MSc, Dip,
Consultant at PHCC, Primary Health
Care Corporation,
Abu Baker Al-Siddiq Health CenterDoha-Qatar
Mobile: +97430188874. P.O. Box 26555.
Email: sahmedana@phcc.gov.qa, sararmusa97@yahoo.com
Received: January 2024. Accepted:
February 2024; Published: March
1, 2024.Citation: Sara Elsheikh
Ahmedana, Musa Basheer Mansour,
Amr Musa Basheer. The Prevention
of Diabetic Ketoacidosis in Patients
with Type 2 Diabetes on Sodium-Glucose
Transport Protein 2 Inhibitors.
World Family Medicine.
March 2024; 22(3): 62-74. DOI: 10.5742/MEWFM.2024.95257631
|
Abstract
Background:
Sodium-Glucose
Transport Protein 2 Inhibitors
(SGLT2Is) effectively control
diabetes. Diabetic ketoacidosis
(DKA) has been reported as
a life-threatening adverse
effect due to SGLT2Is use.
Aim:
This study aims to review
the current evidence of incidence,
predisposing factors and the
prevention of DKA in T2DM
patients on SGLT2Is use.
Methods
and Materials: Two reviewers
have conducted a search strategy
of studies published in English
between August 2012 and November
2020, in EBSCOhost, Google
Scholar, PubMed, Science Direct
and Wiley. Two reviewers independently
assessed the eligibility and
quality of the studies and
extracted the data.
Results:
85 studies were identified
in the initial search; 75
records were removed and finally,
10 studies were included.
Only studies discussing the
prevention of DKA in T2DM
patients on SGLT2Is were selected,
extracted and categorized
into main domains that included
SGLT2Is use inT2DM patients
and DKA (50%), SGLT2Is use
in T2DM patients (20%), the
clinical presentation of DKA
(20%) and DKA prevention (10%).
Six studies showed SGLT2Is
increased the risk of DKA
with very low rates in two
studies. The precipitating
factors of DKA in all included
studies were revealed asstopping
or reducing insulin, trauma,
infection, surgery, severe
acute illness, vigorous exercise,
dehydration, low carbohydrate
intake and excessive alcohol
intake. In two studies DKA
can be prevented by wakefulness
and education, in one study
by closed follow-up, in one
study by regular monitoring
and adjustment of medications
and in two studies by recognition
of patients at risk.
Conclusions:
This review summarized
the prevention of DKA in T2DM
patients on SGLT2Is use with
consideration of incidence,
a summary of evidence and
predisposing factors. Physicians,
health care providers and
patients should be aware of
SGLT2Is use, regular follow
up, precipitating factors,
symptoms, signs and prevention
of DKA.
Keywords:
Sodium-Glucose Transport Protein
2 Inhibitors SGLT2Is, Type
2 diabetes mellitus, Diabetic
Ketoacidosis, Scoping Review.
|
|
