Association of sodium glucose co-transporter-2 inhibitors with risk of diabetic ketoacidosis among hospitalized patients: A multicentre cohort study

作者：Shohinee Sarma, Benazir Hodzic-Santor, Afsaneh Raissi, Michael Colacci, Amol A. Verma, Fahad Razak, Mats Christian Højbjerg Lassen, Michael Fralick · 发表于：Journal of Diabetes and its Complications · 年份：2024 · DOI：10.1016/j.jdiacomp.2024.108827 · 被引用次数：8 · 研究领域：Diabetes and associated disorders、Pancreatitis Pathology and Treatment、Hyperglycemia and glycemic control in critically ill and hospitalized patients

Sodium glucose co-transporter-2 inhibitors (SGLT-2i) are increasingly being used among hospitalized patients. Our objective was to assess the risk of diabetic ketoacidosis (DKA) among hospitalized patients receiving an SGLT-2i. We conducted a multicentre cohort study of patients hospitalized at 19 hospitals. We included patients over 18 years of age who received an SGLT-2i or a dipeptidyl peptidase-4 inhibitor (DPP-4i) in hospital. The primary outcome was the risk of DKA during their hospitalization. 61,517 patients received a DPP-4i and 11,061 received an SGLT-2i. The risk of inpatient DKA was 0.07 % ( N = 41 events) among adults who received a DPP-4i and 0.18 % ( N = 20 events) among adults who received an SGLT-2i; adjusted odds ratio of 3.30 (95 % CI: 1.85–5.72). In hospitalized patients, the absolute risk of DKA was 0.2 %, which corresponded to a three-fold higher relative risk. • We conducted a multicentre cohort study of hospitalized adults to examine the risk of diabetic ketoacidosis (DKA) among patients who received an SGLT2 inhibitor in hospital (SGLT-2i). • The absolute risk of DKA with SGLT-2i was 0.2%, results consistent with a recent meta-analysis of SGLT-2i use in the outpatient setting.