Euglycemic Diabetic Ketoacidosis Accompanied by Severe Hypophosphatemia During Recovery in a Patient With Type 2 Diabetes Being Treated With Canagliflozin/Metformin Combination Therapy

ISPAD Clinical Practice Consensus Guidelines 2018: Type 2 diabetes mellitus in youth

“…Adverse effects include small increases in prevalence of genitourinary infections, particularly among women and uncircumcised men . Canagliflozin has been associated with increased rates of lower extremity amputations in adults at risk for vascular compromise and there have been reports of euglycemic diabetic ketoacidosis in patients on SGLT2 inhibitors . There have been no studies of SGLT2 inhibitors in youth, but several are currently underway.…”

“…107 Canagliflozin has been associated with increased rates of lower extremity amputations in adults at risk for vascular compromise 108 and there have been reports of euglycemic diabetic ketoacidosis in patients on SGLT2 inhibitors. 109 There have been no studies of SGLT2 inhibitors in youth, but several are currently underway. Several events in development may be associated with increased risk for the insulin resistance syndrome, including premature adrenarche, 112 being born small for gestational age (SGA) or to a pregnancy complicated by maternal obesity.…”

Bewusstseinsstörung, Tachypnoe und Tachykardie bei einem 71-jährigen Patienten mit Diabetes mellitus Typ 2

“…Durch die vorbestehende Glukosurie mit konsekutiver Phosphaturie ist es aber tatsächlich zu einer Phosphatverarmung des Organismus gekommen. Inwieweit die Medikation mit SGLT-2-Inhibitoren selbst zu erniedrigten Phosphatreserven führt, ist nicht geklärt [ 14 ].…”