Table 1 Demographics, clinical characteristics, and outcomes of type 2 diabetes mellitus patients on SGLT2i who developed EuDKA or hDKA.
From: SGLT-2 inhibitors associated euglycemic and hyperglycemic DKA in a multicentric cohort
Baseline characteristics | Units | Total DKA (N = 43) | EuDKA (N = 25) | hDKA (N = 18) |
|---|---|---|---|---|
Prevalence | NA | 43/9940 (0.43%) | 25/9940 (0.25%) | 18/9940 (0.18%) |
Age (Mean ± SD) | Years | 55.1 ± 13.0 | 52.4 ± 12.8 | 58.9 ± 12.9 |
Gender | N (%) | |||
Male | 19 (44.1%) | 10 (40%) | 9 (50%) | |
Female | 24 (55.8%) | 15 (60%) | 9 (50%) | |
Ethnicities | N (%) | |||
MENA | 32 (74.4%) | 20 | 12 | |
South-East Asian | 6 (13.9%) | 2 | 4 | |
Others (Filipino, Australian) | 5 (11.6%) | 3 | 2 | |
BMI (Mean ± SD) | kg/m2 | 29.8 ± 6.72 | 30.2 ± 7.19 | 29.4 ± 6.17 |
Fasting glucose (within last 3 months) (Mean ± SD) | mmol/L | 10.6 ± 3.62 | 9.32 ± 2.86 | 12.6 ± 3.88 |
Random blood glucose at admission, Median (IQR) | mmol/L | 12.2 (9.9–19.9) | 10.3 (9.3–11.9) | 21.8 (17.3–26.9) |
Temperature, Median (IQR) | °C | 36.8 (36.6–37) | 36.7 (36.6–36.8) | 36.9 (36.7–37.1) |
HbA1c | mmol/mol | 83.6 | 80.8 | 86.9 |
HbA1c (Mean ± SD) | Percentage | 9.8 ± 1.95 | 9.54 ± 1.82 | 10.1 ± 2.12 |
White cell counts, Median (IQR) | 103/uL | 11.1 (8.25–17.4) | 11.1 (8.9–14.4) | 11.7 (6.65–22.8) |
Creatinine, Median (IQR) | umol/L | 69 (52–106) | 60 (52–85) | 104 (17.1–130) |
Lactate, Median (IQR) | mmol/L | 1.45 (1.1–1.95) | 1.4 (1–1.8) | 1.6 (1.3–2.2) |
Serum pH, Median (IQR) | NA | 7.27 (7.14–7.32) | 7.28 (7.16–7.32) | 7.21 (7.07–7.32) |
Anion Gap, Median (IQR) | mEq/L | 20 (17.5–22.6) | 19 (18–23) | 20 (17.3–21.9) |
Length of stay, Median (IQR) | Days | 5 (3–9.5) | 5 (4–12) | 5 (3–7.75) |
DKA duration, Median (IQR) | Days | 2 (2–4) | 2 (2–3) | 2.5 (2–4) |
Triggering factors | N (%) | |||
Infection | 14 (32.6%) | 4 (16%) | 10 (55.5%) | |
Pancreatitis | 2 (4.7%) | 1 (4%) | 1 (5.5%) | |
Surgery | 1 (2.3%) | 1 (4%) | 0 | |
Insulin non-compliance | 4 (13.7%) | 1 (6.25%) | 3 (23%) | |
Unknown triggers | 22 (51.1%) | |||
Co-morbidities | N (%) | |||
Coronary artery disease | 8 (18.6%) | 4 (16%) | 4 (22.2%) | |
Heart failure | 4 (9.3%) | 3 (12%) | 1 (5.5%) | |
Asthma | 11 (25.6%) | 6 (24%) | 5 (27.7%) | |
Chronic liver Disease | 1 (2.3%) | 0 | 1 (5.5%) | |
Hypertension | 23 (54.8%) | 13 (52%) | 10 (55.5%) | |
Malignancy | 1 (2.3%) | 1 (4%) | 0 | |
Psychiatric disorder | 2 (4.6%) | 0 | 2 (11.1%) | |
Complications of diabetes | N (%) | |||
Retinopathy | 6 (14%) | 4 (16%) | 2 (11.1%) | |
Nephropathy | 7(16.3%) | 6 (24%) | 1 (5.5%) | |
Diabetic Foot | 2(4.7%) | 1 (4%) | 1 (5.5%) | |
Amputation | 1(2.3%) | 0 | 1 (5.5%) | |
Peripheral arterial disease | 2(4.7%) | 2 (8%) | 0 | |
SGLT 2 inhibitors type | N (%) | |||
Dapagliflozin | 31 (72%) | 15 (60%) | 16 (88.8%) | |
Canagliflozin | 3 (7%) | 3 (12%) | 0 | |
Empagliflozin | 9 (20.9%) | 7 (28%) | 2 (11.1%) | |
Current Insulin use | N (%) | 29 (67.4%) | 16 (64%) | 13 (72%) |
Types of insulin | N (%) | |||
Degludec | 2 (4.7%) | 2 (12.5%) | 0 | |
Glargine | 11 (25.6%) | 5 (31.25%) | 6 (46.1%) | |
Aspart plus glargine | 13 (30.2%) | 9 (56.25%) | 4 (30.7%) | |
Insulin pump | 1 (2.3%) | 0 | 1 (7.69%) | |
Lispro/Protamine | 1 (2.3%) | 0 | 1 (7.69%) | |
Mixtard | 2 (4.7%) | 1 (6.25%) | 1 (7.69%) | |
Compliance to insulin | N (%) | 25 (86.2%) | 15 (93.75%) | 10 (76.9%) |
Sulfonylurea | N (%) | 15 (34.9%) | 10 (40%) | 5 (27.7%) |
Metformin | N (%) | 28 (65.1%) | 15 (60%) | 13 (72.2%) |
Thiazolidinediones | N (%) | 15 (34.9%) | 8 (32%) | 7 (38.8%) |
Meglitinides | N (%) | 2 (4.7%) | 0 | 2 (11.1%) |
Alpha-glucosidase inhibitors | N (%) | 1 (2.3%) | 0 | 1 (5.5%0 |
GLP-1 agonist | N (%) | 5 (11.6%) | 3 (12%) | 8 (44.4%) |
DDP-4 inhibitors | N (%) | 17 (39.5%) | 9 (36%) | 8 (44.4%) |
Inhaled Corticosteroids | N (%) | 11 (25.6%) | 6 (24%) | 5 (27.7%) |
In-hospital mortality | N (%) | 1 (2.3%) | 1 (4%) | 0 |
Need for admission to ICU | N (%) | 19 (44.2%) | 11 (44%) | 8 (44.4%) |
