Scandinavian Registry Analysis Shows Ketoacidosis Risk with SGLT2 Inhibitors Persists Beyond First Months in High-Risk Type 2 Diabetes Patients
Registry-based Scandinavian study of over 280,000 type 2 diabetes patients confirms persistent ketoacidosis risk with SGLT2 inhibitors, highest in those with prior episodes, hyperglycemia, or low body weight. Infection is the dominant trigger. Findings support refined patient selection and temporary treatment pauses rather than broad avoidance.
Next steps include prospective validation in electronic health record cohorts and examination of other modern agents such as GLP-1 receptor agonists for comparable rare events. Guideline committees are expected to incorporate the identified risk factors into decision tools within two years.
Ueda et al.: Within 24 months, at least two major diabetes guidelines will add low BMI and prior ketoacidosis as formal SGLT2 inhibitor contraindications or pause criteria, with audit data showing 15 percent drop in events among flagged patients.
Sources (2)
- [1]Primary Source(https://www.thelancet.com/journals/landia/article/PIIS2213-8587(26)00162-2/fulltext)
- [2]Supporting Source(https://jamanetwork.com/journals/jama/fullarticle/2794567)