Diabetic ketoacidosis, sodium glucose transporter-2 inhibitors and the kidney

Biff F. Palmer, Deborah J. Clegg, Simeon I. Taylor, Matthew R. Weir

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Diabetic ketoacidosis is a serious metabolic condition that may occur in patients with either Type 1 or Type 2 diabetes. The accumulation of ketoacids in the serum is a consequence of insulin deficiency and glucagon excess. Sodium Glucose Transporter 2 (SGLT2) inhibitors are novel therapeutic treatments for improving glucose homeostasis in patients with diabetes. Through reductions in glucose reabsorption by the kidney, they lower serum glucose in patients with Type 2 diabetes and they improve glucose control whether used alone or in combination with other therapies. Mechanistically, these drugs increase serum ketoacids and increase glucagon production, which in some individuals, can lead to formation of diabetic ketoacidosis. This review will first focus in how the kidney normally handles ketoacids, and second will discuss how the SGLT2 inhibitors affect the kidney in such a way so as to enhance the risk for development of ketoacidosis in susceptible individuals.

Original languageEnglish (US)
Pages (from-to)1162-1166
Number of pages5
JournalJournal of Diabetes and Its Complications
Issue number6
StatePublished - Aug 1 2016


  • Diabetic ketoacidosis
  • Glucose
  • Kidney
  • Sodium glucose transporter 2 inhibitors
  • Transport maximum

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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