Dapagliflozin/empagliflozin

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Diabetic ketoacidosis, euglycaemic diabetic ketoacidosis and weight loss: 3 case reports In a case series, three patients (two women and one man) aged 56-68 years were described, who developed diabetic ketoacidosis, euglycaemic diabetic ketoacidosis or weight loss following treatment with dapagliflozin or empagliflozin for type 2 diabetes or latent autoimmune diabetes [routes not stated; not all dosages and outcomes stated; time to reaction onsets not stated clearly]. Patient 1: A 56-year-old woman developed diabetic ketoacidosis following treatment with empagliflozin for type 2 diabetes. The woman, who had Hashimoto’s thyroiditis and type 2 diabetes, presented to the hospital with confusion, nausea and vomiting which she had been experiencing since last three days. Her medical history was significant for sleeve gastrectomy. At current presentation, her medical therapy was noted to be consisting of empagliflozin 10mg, metformin, gliclazide, rosuvastatin and levothyroxine sodium. Laboratory investigation revealed elevated levels of blood glucose and capillary ketones. She was diagnosed with diabetic ketoacidosis. She was admitted to the ICU and was treated with potassium replacement, insulin and unspecified fluids. Empagliflozin was discontinued. Further evaluation of her medical history revealed that she had been diagnosed with type 2 diabetes 2 years prior and had started receiving insulin glargine, metformin and gliclazide. Partial response had been achieved. Therefore, three days prior to current presentation, insulin glargine had been discontinued and she had started receiving empagliflozin. Upon current hospitalisation, she was diagnosed with underlying latent autoimmune diabetes of the adult. The diabetic ketoacidosis was considered to have developed secondary to empagliflozin therapy. Subsequently, she was discharged on insulin therapy. Patient 2: A 68-year-old woman developed euglycaemic diabetic ketoacidosis and weight loss following treatment with empagliflozin for presumed type 2 diabetes. The woman, who had presumed diagnosis of type 2 diabetes, was hospitalised with severe euglycaemic diabetic ketoacidosis. Ananmnesis revealed that she had started receiving empagliflozin and metformin three months prior to hospitalisation. Subsequently, she had experienced weight loss, polydipsia, polyurea and severe fatigue leading to current hospitalisation. She was treated with insulin, dextrose and hydration. Thereafter, her ketoacidosis resolved. Empagliflozin was discontinued. Further investigation confirmed previously undiagnosed underlying latent autoimmune diabetes of the adult. Insulin therapy was recommended and she was discharged. The diabetic ketoacidosis and weight loss was considered to have developed secondary to empagliflozin therapy. Patient 3: A 60-year-old man developed diabetic ketoacidosis following treatment with dapagliflozin for latent autoimmune diabetes. The man, who had latent autoimmune diabetes, was hospitalised with severe diabetic ketoacidosis. Anamnesis revealed that he had been re

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