Sodium-Glucose Cotransporter 2 억제제 사용 후 발생한 케톤산증

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a new class of oral antihyperglycemic drugs; inhibition of the cotransporter allows for increased renal glucose excretion that consequently leads to reduced plasma glucose level. We report a rare case of a 73-year-old woman with type 2 diabetes mellitus who developed severe ketoacidosis caused by an SGLT2 inhibitor. At admission, severe ketoacidosis with arterial PH 6.99 was observed, though her serum glucose level of 232 mg/dL was not excessively high. It is necessary to pay attention to patients with type 2 diabetes being treated with an SGLT2 inhibitor, as anorexia, diarrhea, dehydration, and weight loss can develop in conjunction with a high fat/protein diet.