Vnitr Lek 2024, 70(7):E3-E7 | DOI: 10.36290/vnl.2024.092

In-hospital management of non-surgical patients treated with gliflozins

Michal Šitina
Anesteziologicko-resuscitační klinika, FN u sv. Anny, Brno
Oddělení biostatistiky, International Clinical Research Center, FN u sv. Anny, Brno
Ústav patologické fyziologie, Lékařská fakulta, Masarykova univerzita, Brno

A rare but serious complication of the treatment with gliflozins is euglycemic ketoacidosis. It predominantly affects individuals with type 1 or type 2 diabetes. In non-diabetic patients taking gliflozin, the risk of ketoacidosis is minimal. The risk is more pronounced in the perioperative period. Therefore, gliflozin should be discontinued 3-4 days prior to the scheduled major surgery. In case of minor surgery without prolonged fasting, gliflozins can be discontinued only one day before and on the day of surgery. In non-surgical patients, the initiation and continuation of gliflozins during hospitalization appears to be safe, unless risk factors, especially prolonged fasting, are present. Prior to an interventional procedure requiring fasting, such as colonoscopy or TAVI under general anesthesia, it is recommended that gliflozins be discontinued 1-3 days ago. If ketoacidosis is diagnosed, immediate treatment with intravenous insulin is necessary until ketone bodies have dissipated. It is only safe to resume gliflozins after treatment of ketoacidosis if a removable risk factor has been identified.

Keywords: diabetes mellitus, euglycemic ketoacidosis, gliflozins, in-hospital management, SGLT2 inhibitors.

Accepted: November 11, 2024; Published: November 14, 2024  Show citation

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Šitina M. In-hospital management of non-surgical patients treated with gliflozins. Vnitr Lek. 2024;70(7):E3-7. doi: 10.36290/vnl.2024.092.
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