SGLT2 inhibitors tied to ketoacidosis in latent autoimmune diabetes
Sodium-glucose co-transporter-2 (SGLT2) inhibitors can cause ketoacidosis in patients with latent autoimmune diabetes (LADA), a report on three cases in the American Journal of Medicine confirms.
"We emphasize the importance of early recognition of those at risk through the clinical risk score, and suggest targeted antibody testing be undertaken prior to consideration of SGLT2 inhibitor therapy," Dr. Brendan J. Nolan of Northern Hospital in Epping, Victoria, Australia, and colleagues write.
Up to 10% of adult-onset diabetes is due to latent autoimmune disease, in which a person has circulating islet autoantibodies but does not initially require insulin, the authors explain.
"A lean BMI has traditionally been a clinical feature that arouses clinical suspicion of latent autoimmune diabetes and prompts islet antibody testing," they add. "However, with the current obesity epidemic, bodyweight or BMI is no longer a reliable way of distinguishing latent autoimmune diabetes from type 2 diabetes."
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