Nigerian internal medicine specialist Dr. Jerry Adeyemo, based in Germany, has warned about a rare but serious complication associated with SGLT2 inhibitors, a widely used class of drugs for managing Type 2 diabetes.
Dr. Adeyemo’s study focuses on a 63-year-old male patient with Type 2 diabetes and cardiovascular disease who developed euglycemic diabetic ketoacidosis, euDKA, a life-threatening condition that can occur even when blood sugar levels appear normal.
Dr. Adeyemo explains: “Diabetic ketoacidosis, DKA, is a dangerous condition where the body, unable to properly utilize glucose due to insufficient insulin, starts breaking down fats for energy.
“This process leads to an excessive buildup of ketones, making the blood acidic and causing severe metabolic imbalances.”
“Unlike typical DKA, which is associated with extremely high blood sugar levels, euDKA can develop even when glucose levels appear normal, making diagnosis more challenging.
“The patient, who had been prescribed empagliflozin, an SGLT2 inhibitor, experienced nausea, abdominal pain, fatigue, and mild shortness of breath. Despite well-controlled blood sugar levels, lab tests revealed severe metabolic acidosis (pH 7.22) and elevated ketone levels, confirming euDKA.”
Dr. Adeyemo warns: “The absence of extreme hyperglycemia delayed diagnosis, emphasizing the need for heightened clinical awareness.
SGLT2 inhibitors, such as empagliflozin, have revolutionized diabetes treatment by lowering blood sugar and providing cardiovascular and kidney benefits. However, as Dr. Adeyemo’s report highlights, they also carry the risk of euDKA, a complication that can be easily overlooked.
He advised: “Clinicians must maintain a high index of suspicion for metabolic acidosis in patients on these medications.”
He also urges healthcare providers to educate patients on recognizing early symptoms, such as nausea, excessive thirst, confusion, and rapid breathing, to prevent severe complications.
Also, Dr. Adeyemo is actively working to bridge the knowledge gap between diabetes and heart disease. His published book, “Diabetes and Cardiovascular Diseases: Your Guide to Health and Wellness,” co-authored with a Nigerian cardiologist in Germany, offers comprehensive insights into diabetes management and associated risks.
Additionally, his book, “The ABC of Hypertension,” simplifies high blood pressure management for the general public, addressing a condition that disproportionately affects diabetic and heart disease patients.
Recognizing EuDKA: Symptoms like nausea, abdominal pain, and fatigue in diabetic patients on SGLT2 inhibitors should raise concern.
Risk factors: Dehydration, infections, surgery, and reduced insulin doses can trigger euDKA.
Balancing benefits and risks: While SGLT2 inhibitors offer cardiovascular and renal benefits, patients must be carefully selected and monitored.
Dr. Adeyemo’s work continues to ensure better health outcomes by raising awareness of potential diabetes complications and the need for careful medication management.
