The catabolic triad: case report of fasting, major cardiac surgery and sodium-glucose co-transporter 2 inhibitors leading to perioperative euglycaemic ketoacidosis

分解代谢三联征:禁食、重大心脏手术和钠-葡萄糖协同转运蛋白2抑制剂导致围手术期正常血糖性酮症酸中毒的病例报告

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Abstract

Sodium-glucose co-transporter-2 inhibitors (SGLT2i) are novel oral hypoglycaemic agents. For patients with diabetes mellitus, without a prior history of myocardial infarction or atherosclerotic disease, SGLT2i have been shown to reduce incident heart failure and worsening renal function. SGLT2i therapy is increasing among patients presenting for cardiac surgery. However, the perioperative use of SGLT2i carries a significant risk of euglycaemic diabetic ketoacidosis, due to their catabolic mechanism of action. This case report demonstrates euglycaemic ketoacidosis post-coronary artery bypass grafting secondary to SGLT2i, highlighting the multiple risk factors and consequences of this iatrogenic complication.

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