Sodium–Glucose Cotransporter 2 Inhibitor–Linked Pericolonoscopy Hyperketonemia: A Retrospective Study
Study found colonoscopy and its preparation may predispose to low grade ketosis in this group regardless of treatment (18% [14/77] in sodium–glucose cotransporter 2 inhibitors [SGLT2i] and 15.7% [49/313] in non-SGLT2i group; P= 0.589), with no severe cases documented.
Source:
Diabetes Care
SPS commentary:
The authors note that of the 14 cases of SGLT2i-associated hyperketonaemia, one was prescribed insulin and instructions on pre-procedure SGLT2i withholding were documented in 11 cases. Withholding was inconsistent – 5 were instructed to withhold for 24 h, and three each were instructed to withhold for 48 and 72 hours. As no severe cases were documented, they suggest that colonoscopy may still proceed in situations where SGLT2i agents are stopped later than recommended, with vigilance toward identifying ketoacidosis until adequate oral intake is established.