SGLT2 drugs like Invokana linked to increased diabetic ketoacidosis risk

A new study determined that people who take the SGLT2 inhibitor class of diabetes medications face a higher risk of diabetic ketoacidosis (DKA).

The study found that people who take SGLT2 inhibitor drugs face a higher DKA risk than those who take DPP-4 inhibitors. The study also found that the drug could cause infections.

The study demonstrates that DKA seems to be a side effect of SGLT2 inhibitor drugs, according to Kristian Filion of the Lady Davis Institute at Jewish General Hospital in Montreal, Canada.

“There was some uncertainty about how much the risk of DKA was, so we wanted to get a more precise estimate of the risk. We found a threefold increased risk,” Filion said.

SGLT2 inhibitors make the kidneys get rid of blood sugar via urination, lowering blood sugar levels, according to the U.S. Food and Drug Administration. Insulin production also slows when the blood sugar is lowered, according to NYU Langone Health’s Dr. Akankasha Goyal. The body needs insulin to transport sugar from blood to cells.

The body uses stored fat for energy when insulin levels are low. Ketones result from this, according to the American Diabetes Association. Ketone build-up in the blood can cause DKA.

“DKA is a diabetic emergency. Someone in DKA needs to be hospitalized,” Goyal said. While this condition is uncommon in type 2 diabetics, it can be fatal if left untreated.

The study involved over 200,000 patients who used SGLT2 inhibitors from 2013 to 2018. They were compared with a matched patient cluster who took DPP-4 inhibitors.

512 people in the study developed DKA. The DKA risk was almost three times bigger in those who took SGLT2 inhibitors, and the risk differed with the type of SGLT2 inhibitor used.

The DKA risk is the highest when patients start taking SGLT2 inhibitors, according to Goyal. Staying hydrated can prevent DKA. One should always consult with a doctor before taking a new drug.

Invokana, Jardiance and Farxiga are examples of SGLT2 inhibitor drugs, a fairly new class of diabetes drugs which is taken orally. This class of medication can reduce heart attack, heart failure, kidney disease and death from heart disease risks.

Invokana has been linked in the past with ketoacidosis, kidney failure, leg/foot amputations and the “flesh eating” disease necrotizing fasciitis. FDA warnings have warned of leg/foot amputation, kidney failure and ketoacidosis risks associated with Invokana in the past.


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Nadrich & Cohen, LLP

Nadrich & Cohen, LLP is a California personal injury law firm with offices in Los Angeles, San Francisco, Modesto, Fresno, Tracy and Palm Desert. The firm has been representing victims of dangerous drugs since 1990 and has recovered over $350,000,000 on behalf of clients in that time.