Ketosis and ketoacidosis in hospitalized patients receiving SGLT2 inhibitor therapy
Authors' conclusion
Ketosis following inpatient SGLT2i administration was infrequent and generally occurred in the setting of known precipitants. These results suggest that, in hospitalized patients selected by clinicians to receive SGLT2i, clinically significant ketone accumulation is low in prevalence.
Study context
- Population
- Adults with T2D admitted for >24 h who received SGLT2i in hospital777 had ketones checked
- Participants
- 1,511 adults
- Outcome
- Rates of ketosis, ketoacidosis and acidosis relative to the first in-hospital SGLT2i dose
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Peak ketone levels after first SGLT2i dose
- Peak ketones >1 mmol/L
- 12.6%
- Peak ketones >3 mmol/L
- 2.8%
- Biochemical ketoacidosis before first SGLT2i dose
- 1.7%
- Biochemical ketoacidosis after first SGLT2i dose
- 0.7%
- Acidosis (irrespective of ketones) before first SGLT2i dose
- 16.8%
- Acidosis (irrespective of ketones) after first SGLT2i dose
- 5.5%
Observational data: associations, not effects.
Further findings
Ketone testing
- Patients with ketone levels checked
- 777 (51.4%)
Precipitants of ketones >3 mmol/L post-SGLT2i
- Ketosis with procedure/surgery, sepsis, reduced oral intake or critical illness
- 11 out of 12
Patients admitted with HF
- Ketone level >2 mmol/L
- 0
Original publication
Ketosis and ketoacidosis in hospitalized patients receiving SGLT2 inhibitor therapy. Diabetes Obes Metab. Published 11 August 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →