Home
World Journal of Advanced Research and Reviews
International Journal with High Impact Factor for fast publication of Research and Review articles

Main navigation

  • Home
    • Journal Information
    • Editorial Board Members
    • Reviewer Panel
    • Abstracting and Indexing
    • Journal Policies
    • Our CrossMark Policy
    • Publication Ethics
    • Issue in Progress
    • Current Issue
    • Past Issues
    • Instructions for Authors
    • Article processing fee
    • Track Manuscript Status
    • Get Publication Certificate
    • Join Editorial Board
    • Join Reviewer Panel
  • Contact us
  • Downloads

eISSN: 2581-9615 || CODEN: WJARAI || Impact Factor 8.2 ||  CrossRef DOI

Research and review articles are invited for publication in March 2026 (Volume 29, Issue 3) Submit manuscript

Incidence of ketoacidosis in diabetic patients treated with sodium–glucose cotransporter-2 inhibitors: A prospective cohort study

Breadcrumb

  • Home
  • Incidence of ketoacidosis in diabetic patients treated with sodium–glucose cotransporter-2 inhibitors: A prospective cohort study

Issa Afif Kawalit *, Muhand Salama Eltwal, Asad Ibrahim Al-Tirawi and Abbas Y El-Khatib

Department of Nephrology, Amman Hospital, Amman, Jordan.
 
Research Article
World Journal of Advanced Research and Reviews, 2024, 24(02), 625-630
Article DOI: 10.30574/wjarr.2024.24.2.3305
DOI url: https://doi.org/10.30574/wjarr.2024.24.2.3305
 
Received 19 September 2024; revised on 31 October 2024; accepted on 02 November 2024
 
Introduction: Sodium–glucose cotransporter 2 inhibitors (SGLT2is) have gained significant attention for their benefits in managing type 2 diabetes mellitus (T2DM), particularly in patients with chronic kidney disease (CKD) and heart failure. However, the potential for SGLT2is to increase the risk of ketoacidosis, particularly euglycemic diabetic ketoacidosis (EDKA), warrants further investigation. This prospective cohort study assesses the incidence of ketoacidosis among T2DM patients treated with SGLT2is and examines related risk factors.
Methods: This is a prospective study included 575 patients with T2DM. Patients over 18 years undergoing SGLT2i therapy were followed for six months. Baseline demographics, clinical history, glucose management practices, and medication use, with an emphasis on SGLT2is, were recorded. Blood gas analysis (BGA) and urine ketones were measured monthly. Ketoacidosis was defined by urine ketone positivity with pH <7.30, bicarbonate (HCO3) ≤18 mEq/L, and an elevated anion gap.
Results: Out of 575 patients, 35.6% (205) had positive urine ketones at least once during the study, with 11 patients (0.7%) meeting ketoacidosis criteria. Patients with ketoacidosis had a mean hospital stay of 8.2 days compared to 5.4 days in non-ketoacidosis patients (p = 0.02). No in-hospital mortality occurred among ketoacidosis patients.
Conclusion: Ketoacidosis was rare but clinically relevant in T2DM patients on SGLT2is. The incidence of euglycemic ketoacidosis highlights the need for monitoring and identifying high-risk individuals early during SGLT2i treatment initiation.
 
SGLT2 inhibitors; Euglycemic diabetic ketoacidosis; Type 2 diabetes mellitus
 
https://wjarr.com/sites/default/files/fulltext_pdf/WJARR-2024-3305.pdf

Preview Article PDF

Issa Afif Kawalit, Muhand Salama Eltwal, Asad Ibrahim Al-Tirawi and Abbas Y El-Khatib. Incidence of ketoacidosis in diabetic patients treated with sodium–glucose cotransporter-2 inhibitors: A prospective cohort study. World Journal of Advanced Research and Reviews, 2024, 24(2), 625-630. Article DOI: https://doi.org/10.30574/wjarr.2024.24.2.3305

Copyright © Author(s). All rights reserved. This article is published under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits use, sharing, adaptation, distribution, and reproduction in any medium or format, as long as appropriate credit is given to the original author(s) and source, a link to the license is provided, and any changes made are indicated.

All statements, opinions, and data contained in this publication are solely those of the individual author(s) and contributor(s). The journal, editors, reviewers, and publisher disclaim any responsibility or liability for the content, including accuracy, completeness, or any consequences arising from its use.

Get Certificates

Get Publication Certificate

Download LoA

Check Corssref DOI details

Issue details

Issue Cover Page

Editorial Board

Table of content

Copyright © 2026 World Journal of Advanced Research and Reviews - All rights reserved

Developed & Designed by VS Infosolution