Researchers have issued a new alert over a common pill taken by more than 1 million people in the UK daily. The medication is commonly prescribed to people with type 2 diabetes, and a third of those with the condition take these drugs.
Link between ketoacidosis and SGLT2 inhibitors
New research has highlighted the link between ketoacidosis and SGLT2 inhibitors such as dapagliflozin, empagliflozin, canagliflozin, and ertugliflozin. Ketoacidosis occurs when harmful ketones build up in the blood, triggering a life-threatening 'attack'. Swedish researchers say the complication could be more common in people taking the drug if they have low body weight. That could be around 10 per cent of those taking the pills.
Separate research found deaths from ketoacidosis are rising in the UK. Anyone concerned should not stop taking the pills but should talk to their GP.
Study details and risk factors
The new study in The Lancet Diabetes and Endocrinology journal was written by researchers from Karolinska Institute, who analysed the health records of 280,000 type 2 diabetes patients treated with SGLT2 inhibitors. The drugs are prescribed to help lower blood sugar levels, boost weight loss and protect against heart failure and kidney disease. The tablets are taken once a day.
As well as low body weight, other risk factors include having had ketoacidosis before, having high blood sugar or suffering malnutrition. Those with a history of dangerously low blood sugar are also at higher risk. Ketoacidosis can be triggered by an infection and can in turn trigger kidney problems and stroke.
Expert comment and rising cases
"SGLT2 inhibitors provide medical benefits for many patients," said Peter Ueda, assistant professor at the Department of Medicine in the Karolinska Institute. "Our findings are not primarily about avoiding treatment, but about improving our ability to identify high-risk patients and use these medicines more safely."
Last year, researchers from Imperial College London found ketoacidosis cases had risen by 81 per cent between 2015 and 2023. Symptoms can include feeling thirsty and needing to urinate more often than usual as well as stomach pain, nausea or vomiting, diarrhoea and blurry vision, unusually deep breathing, fruity-smelling breath and feeling extremely tired, sleepy or confused. Ketoacidosis can trigger fatal multiple organ failure.
