Association of sodium glucose co-transporter-2 inhibitors with risk of diabetic ketoacidosis among hospitalized patients: A multicentre cohort study

Shohinee Sarma; Benazir Hodzic-Santor; Afsaneh Raissi; Michael Colacci; Amol A Verma; Fahad Razak; Mats C Højbjerg Lassen; Michael Fralick

doi:10.1016/j.jdiacomp.2024.108827

Association of sodium glucose co-transporter-2 inhibitors with risk of diabetic ketoacidosis among hospitalized patients: A multicentre cohort study

Shohinee Sarma, Benazir Hodzic-Santor, Afsaneh Raissi, Michael Colacci, Amol A Verma, Fahad Razak, Mats C Højbjerg Lassen, Michael Fralick

Department of Cardiology

6 Citations (Scopus)

Abstract

INTRODUCTION: Sodium glucose co-transporter-2 inhibitors (SGLT-2i) are increasingly being used among hospitalized patients. Our objective was to assess the risk of diabetic ketoacidosis (DKA) among hospitalized patients receiving an SGLT-2i.

RESEARCH DESIGN AND METHODS: We conducted a multicentre cohort study of patients hospitalized at 19 hospitals. We included patients over 18 years of age who received an SGLT-2i or a dipeptidyl peptidase-4 inhibitor (DPP-4i) in hospital. The primary outcome was the risk of DKA during their hospitalization.

RESULTS: 61,517 patients received a DPP-4i and 11,061 received an SGLT-2i. The risk of inpatient DKA was 0.07 % (N = 41 events) among adults who received a DPP-4i and 0.18 % (N = 20 events) among adults who received an SGLT-2i; adjusted odds ratio of 3.30 (95 % CI: 1.85-5.72).

CONCLUSIONS: In hospitalized patients, the absolute risk of DKA was 0.2 %, which corresponded to a three-fold higher relative risk.

Original language	English
Article number	108827
Journal	Journal of Diabetes and its Complications
Volume	38
Issue number	9
Pages (from-to)	108827
ISSN	1056-8727
DOIs	https://doi.org/10.1016/j.jdiacomp.2024.108827
Publication status	Published - Sept 2024

Keywords

Humans
Diabetic Ketoacidosis/epidemiology
Sodium-Glucose Transporter 2 Inhibitors/therapeutic use
Male
Female
Middle Aged
Hospitalization/statistics & numerical data
Cohort Studies
Diabetes Mellitus, Type 2/drug therapy
Aged
Adult
Dipeptidyl-Peptidase IV Inhibitors/therapeutic use
Risk Factors
Hypoglycemic Agents/adverse effects

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Sarma, S., Hodzic-Santor, B., Raissi, A., Colacci, M., Verma, A. A., Razak, F., Højbjerg Lassen, M. C., & Fralick, M. (2024). Association of sodium glucose co-transporter-2 inhibitors with risk of diabetic ketoacidosis among hospitalized patients: A multicentre cohort study. Journal of Diabetes and its Complications, 38(9), 108827. Article 108827. https://doi.org/10.1016/j.jdiacomp.2024.108827

Association of sodium glucose co-transporter-2 inhibitors with risk of diabetic ketoacidosis among hospitalized patients: A multicentre cohort study. / Sarma, Shohinee; Hodzic-Santor, Benazir; Raissi, Afsaneh et al.
In: Journal of Diabetes and its Complications, Vol. 38, No. 9, 108827, 09.2024, p. 108827.

Research output: Contribution to journal › Journal article › Research › peer-review

Sarma, S, Hodzic-Santor, B, Raissi, A, Colacci, M, Verma, AA, Razak, F, Højbjerg Lassen, MC & Fralick, M 2024, 'Association of sodium glucose co-transporter-2 inhibitors with risk of diabetic ketoacidosis among hospitalized patients: A multicentre cohort study', Journal of Diabetes and its Complications, vol. 38, no. 9, 108827, pp. 108827. https://doi.org/10.1016/j.jdiacomp.2024.108827

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title = "Association of sodium glucose co-transporter-2 inhibitors with risk of diabetic ketoacidosis among hospitalized patients: A multicentre cohort study",

abstract = "INTRODUCTION: Sodium glucose co-transporter-2 inhibitors (SGLT-2i) are increasingly being used among hospitalized patients. Our objective was to assess the risk of diabetic ketoacidosis (DKA) among hospitalized patients receiving an SGLT-2i.RESEARCH DESIGN AND METHODS: We conducted a multicentre cohort study of patients hospitalized at 19 hospitals. We included patients over 18 years of age who received an SGLT-2i or a dipeptidyl peptidase-4 inhibitor (DPP-4i) in hospital. The primary outcome was the risk of DKA during their hospitalization.RESULTS: 61,517 patients received a DPP-4i and 11,061 received an SGLT-2i. The risk of inpatient DKA was 0.07 \% (N = 41 events) among adults who received a DPP-4i and 0.18 \% (N = 20 events) among adults who received an SGLT-2i; adjusted odds ratio of 3.30 (95 \% CI: 1.85-5.72).CONCLUSIONS: In hospitalized patients, the absolute risk of DKA was 0.2 \%, which corresponded to a three-fold higher relative risk.",

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author = "Shohinee Sarma and Benazir Hodzic-Santor and Afsaneh Raissi and Michael Colacci and Verma, \{Amol A\} and Fahad Razak and \{H{\o}jbjerg Lassen\}, \{Mats C\} and Michael Fralick",

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T1 - Association of sodium glucose co-transporter-2 inhibitors with risk of diabetic ketoacidosis among hospitalized patients

T2 - A multicentre cohort study

AU - Sarma, Shohinee

AU - Hodzic-Santor, Benazir

AU - Raissi, Afsaneh

AU - Colacci, Michael

AU - Verma, Amol A

AU - Razak, Fahad

AU - Højbjerg Lassen, Mats C

AU - Fralick, Michael

PY - 2024/9

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N2 - INTRODUCTION: Sodium glucose co-transporter-2 inhibitors (SGLT-2i) are increasingly being used among hospitalized patients. Our objective was to assess the risk of diabetic ketoacidosis (DKA) among hospitalized patients receiving an SGLT-2i.RESEARCH DESIGN AND METHODS: We conducted a multicentre cohort study of patients hospitalized at 19 hospitals. We included patients over 18 years of age who received an SGLT-2i or a dipeptidyl peptidase-4 inhibitor (DPP-4i) in hospital. The primary outcome was the risk of DKA during their hospitalization.RESULTS: 61,517 patients received a DPP-4i and 11,061 received an SGLT-2i. The risk of inpatient DKA was 0.07 % (N = 41 events) among adults who received a DPP-4i and 0.18 % (N = 20 events) among adults who received an SGLT-2i; adjusted odds ratio of 3.30 (95 % CI: 1.85-5.72).CONCLUSIONS: In hospitalized patients, the absolute risk of DKA was 0.2 %, which corresponded to a three-fold higher relative risk.

AB - INTRODUCTION: Sodium glucose co-transporter-2 inhibitors (SGLT-2i) are increasingly being used among hospitalized patients. Our objective was to assess the risk of diabetic ketoacidosis (DKA) among hospitalized patients receiving an SGLT-2i.RESEARCH DESIGN AND METHODS: We conducted a multicentre cohort study of patients hospitalized at 19 hospitals. We included patients over 18 years of age who received an SGLT-2i or a dipeptidyl peptidase-4 inhibitor (DPP-4i) in hospital. The primary outcome was the risk of DKA during their hospitalization.RESULTS: 61,517 patients received a DPP-4i and 11,061 received an SGLT-2i. The risk of inpatient DKA was 0.07 % (N = 41 events) among adults who received a DPP-4i and 0.18 % (N = 20 events) among adults who received an SGLT-2i; adjusted odds ratio of 3.30 (95 % CI: 1.85-5.72).CONCLUSIONS: In hospitalized patients, the absolute risk of DKA was 0.2 %, which corresponded to a three-fold higher relative risk.

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KW - Sodium-Glucose Transporter 2 Inhibitors/therapeutic use

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KW - Female

KW - Middle Aged

KW - Hospitalization/statistics & numerical data

KW - Cohort Studies

KW - Diabetes Mellitus, Type 2/drug therapy

KW - Aged

KW - Adult

KW - Dipeptidyl-Peptidase IV Inhibitors/therapeutic use

KW - Risk Factors

KW - Hypoglycemic Agents/adverse effects

UR - https://www.scopus.com/pages/publications/85200048292

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DO - 10.1016/j.jdiacomp.2024.108827

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SN - 1056-8727

VL - 38

SP - 108827

JO - Journal of Diabetes and its Complications

JF - Journal of Diabetes and its Complications

IS - 9

M1 - 108827

ER -

Association of sodium glucose co-transporter-2 inhibitors with risk of diabetic ketoacidosis among hospitalized patients: A multicentre cohort study

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