title: Non-occlusive Mesenteric Ischemia with Diabetic Ketoacidosis and Lactic Acidosis Following the Administration of a Sodium Glucose Co-transporter 2 Inhibitor.
abstract: We herein describe a patient with non-occlusive mesenteric ischemia (NOMI) potentially associated with the administration of a sodium glucose co-transporter 2 (SGLT2) inhibitor. A 60-year-old man with type 1 diabetes was transferred to our hospital due to vomiting and respiratory distress. He was treated with insulin, metformin and a SGLT2 inhibitor, which had recently been added. He was diagnosed with intestinal ischemia complicated by diabetic ketoacidosis and lactic acidosis. Urgent exploratory surgery was performed, and the gangrenous bowel was resected. Histological findings confirmed the diagnosis of NOMI. The administration of SGLT2 inhibitors therefore requires certain exceptions for type 1 diabetes and cautious monitoring for the occurrence of these possible adverse effects.
authors.affiliation: Diabetes Center, Ebina General Hospital, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Gocho
authors.forename: Ema
authors.initials: E
authors.lastname: Aoki
authors.forename: Chiho
authors.initials: C
authors.lastname: Okada
authors.forename: Kazuki
authors.initials: K
authors.lastname: Omura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hirashima
authors.forename: Natsuko
authors.initials: N
authors.lastname: Suzuki
authors.forename: Hideki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Yasue
authors.initials: Y
authors.lastname: Omori
mesh_terms: D000140:Acidosis, Lactic / Q000139:chemically induced; D000068896:Canagliflozin / Q000009:adverse effects* / Q000627:therapeutic use; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D016883:Diabetic Ketoacidosis / Q000139:chemically induced*; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D065666:Mesenteric Ischemia / Q000139:chemically induced* / Q000601:surgery; D008875:Middle Aged; D016491:Peripheral Vascular Diseases; D051269:Sodium-Glucose Transporter 1 / Q000037:antagonists & inhibitors*
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D051269:Sodium-Glucose Transporter 1; D000068896:Canagliflozin