Clinical characteristics and outcomes of diabetes‐related ketoacidosis ( DKA ) in sodium‐glucose co‐transporter‐2 inhibitor ( SGLT2i ) users with type 2 diabetes
Authors' conclusion
Despite lower admission glucose, more pronounced acidosis, and a higher incidence of hypokalaemia episodes, clinical outcomes were similar between the matched population of SGLT2i users and non-users. This may be attributed to earlier identification of euglycaemic DKA, timely intervention, as well as the distinct pathophysiological profile of SGLT2i-associated DKA. Improved education on risk factors and preventive strategies is warranted with SGLT2i therapy.
Study context
- Population
- Acute DKA admissions in people with T2D, 18 UK hospitals (April 2018-March 2024), standardised DKA protocols (DEKODE cohort)534 matched analysed
- Participants
- 267 vs 793
- Comparison
- SGLT2i users vs non-users with T2D admitted with DKA
- SGLT2i usersn = 267
- Non-usersn = 793reference
- Outcome
- DKA features and outcomes in matched cohort
Methodological detailsmulticentre, propensity score matched
- Multicentre
- Propensity score matched
Pooled result
As reported in the abstract
SGLT2i identified as sole precipitant
30.3% of cases
Further pooled results
Meta-summary of SGLT2i-associated DKA in T2D
- Cases / studies
- 1024 cases from 247 studies
- Median age
- 54.6 years
- Male
- 49.7%
- Median diabetes duration
- 10 years
- Median pH
- 7.1
- Ketones
- 5.7 mmol/L
- Glucose
- 10.6 mmol/L
- DKA typically developed after SGLT2i use of
- 2 months
- Requiring ICU admission
- 21.1%
Original publication
Clinical characteristics and outcomes of diabetes‐related ketoacidosis ( DKA ) in sodium‐glucose co‐transporter‐2 inhibitor ( SGLT2i ) users with type 2 diabetes. Diabetes Obes Metab. Published 8 September 2025. doi:10.
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