A Population-Based Study of SGLT2 Inhibitor-Associated Postoperative Diabetic Ketoacidosis in Patients with Type 2 Diabetes

David Tak Wai Lui (), Tingting Wu (), Ivan Chi Ho Au, Xiaodong Liu, Matrix Man Him Fung, Chi Ho Lee, Carol Ho Yi Fong, Yu Cho Woo, Brian Hung Hin Lang, Kathryn Choon Beng Tan and Carlos King Ho Wong ()
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David Tak Wai Lui: The University of Hong Kong
Tingting Wu: The University of Hong Kong
Ivan Chi Ho Au: The University of Hong Kong
Xiaodong Liu: The University of Hong Kong
Matrix Man Him Fung: The University of Hong Kong
Chi Ho Lee: The University of Hong Kong
Carol Ho Yi Fong: The University of Hong Kong
Yu Cho Woo: The University of Hong Kong
Brian Hung Hin Lang: The University of Hong Kong
Kathryn Choon Beng Tan: The University of Hong Kong
Carlos King Ho Wong: The University of Hong Kong

Drug Safety, 2023, vol. 46, issue 1, No 4, 53-64

Abstract: Abstract Introduction and Objectives Operations are a major precipitating factor for sodium-glucose co-transporter 2 inhibitor (SGLT2i)-associated diabetic ketoacidosis (DKA). This study aimed to investigate the risks of SGLT2i-associated postoperative DKA. Methods We analysed a population-based cohort of patients with type 2 diabetes who underwent operations during 2015–2020. Patients with SGLT2i prescriptions within 6 months before operations were assigned to the SGLT2i group, while others were assigned to the control group. Inverse probability treatment weighting with propensity scores was used to balance the baseline covariates. Postoperative DKA was defined as DKA within 30 days postoperatively. Results Overall, 147,115 subjects were included (3,419 SGLT2i users; 143,696 controls). Preoperative SGLT2i exposure was associated with increased risks of postoperative DKA (incidence = 6.40/1,000 person-years; incidence rate ratio [IRR] 6.33, 95% confidence interval [CI] 5.57–7.18; p

Date: 2023
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DOI: 10.1007/s40264-022-01247-3

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