Sodium‐glucose co‐transporter‐2 inhibitors and the risk of ketoacidosis in patients with type 2 diabetes mellitus: A nationwide population‐based cohort study
Aims To estimate the risk of diabetic ketoacidosis (DKA) associated with sodium‐glucose co‐transporter‐2 (SGLT2) inhibitor treatment compared with the risk associated with dipeptidyl‐peptidase‐4 (DPP‐4) inhibitor treatment. Methods A nationwide population‐based cohort study using claims data from th...
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| Veröffentlicht in: | Diabetes, obesity & metabolism obesity & metabolism, 2018-08, Vol.20 (8), p.1852-1858 |
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| creator | Kim, Young‐Gun Jeon, Ja Young Han, Seung Jin Kim, Dae Jung Lee, Kwan‐Woo Kim, Hae Jin |
| description | Aims
To estimate the risk of diabetic ketoacidosis (DKA) associated with sodium‐glucose co‐transporter‐2 (SGLT2) inhibitor treatment compared with the risk associated with dipeptidyl‐peptidase‐4 (DPP‐4) inhibitor treatment.
Methods
A nationwide population‐based cohort study using claims data from the Korean Health Insurance Review and Assessment Service from January 1, 2013 to June 30, 2017 was performed. A total of 56 325 patients who were started on SGLT2 inhibitors were included in this study and were matched with same number of patients who were started on DPP‐4 inhibitors using propensity score matching. Kaplan–Meier curves and Cox proportional hazards regression analyses were used to estimate the risk of hospitalization for DKA.
Results
The risk of hospitalization for DKA was not increased in SGLT2 inhibitor users vs DPP‐4 inhibitor users (hazard ratio [HR] 0.956, 95% confidence interval [CI] 0.581‐1.572; P = .996). The incidence rate of hospitalization for DKA during the first 30 days after initiation of the SGLT2 inhibitor was 2.501 cases per 1000 person‐years, which was higher than the rate during 3 years (0.614 cases per 1000 person‐years). SGLT2 inhibitor use was associated with a higher HR in patients with diabetic microvascular complications (HR 2.044, 95% CI 0.900‐4.640; P = .088) and in patients taking diuretics (HR 3.648, 95% CI 0.720‐18.480; P = .118), although these associations were not statistically significant.
Conclusion
We found that SGLT2 inhibitor treatment did not increase the risk of DKA compared with DPP‐4 inhibitor treatment. Our findings suggest that patients prescribed diuretics or those with microvascular complications may have a greater tendency to be hospitalized for DKA. |
| doi_str_mv | 10.1111/dom.13297 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2018021575</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2018021575</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3537-eed2d4cef5cd281048b86f5843dda96192382ba3958d7d04d659da10a92a5a883</originalsourceid><addsrcrecordid>eNp1kc1u1TAQhS0EoqWw4AWQJTZlkdY_cWKzq8qvVNQFsI6ceMJ1m8TBY-vq7ngEXoIX40kw9xYWSMxm5kifzhzpEPKUszNe5tyF-YxLYdp75JjXjayKaO7vb1Fpw8QReYR4wxirpW4fkiNhVGNq0R6THx-D83n--e37lykPAYEOoYgU7YJriAliUYL6ZeN7n0JEahdH0wZo9HhLw0hvIQU7eBfQY-HoapOHJSHd-rShabcCFdR520MCpDNMk08ZX9ILuhQyLFvvgK5hzdNelne9RXAlx6b8p5iy2z0mD0Y7ITy52yfk85vXny7fVVfXb99fXlxVg1SyrQCccPUAoxqc0JzVutfNqHQtnbOm4UZILXorjdKudax2jTLOcmaNsMpqLU_I6cF3jeFrBkzd7HEoke0CIWMnGNdMcNWqgj7_B70JOS4lXaEaLUTLjSzUiwM1xIAYYezW6Gcbdx1n3e_uutJdt--usM_uHHM_g_tL_imrAOcHYOsn2P3fqXt1_eFg-Qti06oA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2068227193</pqid></control><display><type>article</type><title>Sodium‐glucose co‐transporter‐2 inhibitors and the risk of ketoacidosis in patients with type 2 diabetes mellitus: A nationwide population‐based cohort study</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Kim, Young‐Gun ; Jeon, Ja Young ; Han, Seung Jin ; Kim, Dae Jung ; Lee, Kwan‐Woo ; Kim, Hae Jin</creator><creatorcontrib>Kim, Young‐Gun ; Jeon, Ja Young ; Han, Seung Jin ; Kim, Dae Jung ; Lee, Kwan‐Woo ; Kim, Hae Jin</creatorcontrib><description>Aims
To estimate the risk of diabetic ketoacidosis (DKA) associated with sodium‐glucose co‐transporter‐2 (SGLT2) inhibitor treatment compared with the risk associated with dipeptidyl‐peptidase‐4 (DPP‐4) inhibitor treatment.
Methods
A nationwide population‐based cohort study using claims data from the Korean Health Insurance Review and Assessment Service from January 1, 2013 to June 30, 2017 was performed. A total of 56 325 patients who were started on SGLT2 inhibitors were included in this study and were matched with same number of patients who were started on DPP‐4 inhibitors using propensity score matching. Kaplan–Meier curves and Cox proportional hazards regression analyses were used to estimate the risk of hospitalization for DKA.
Results
The risk of hospitalization for DKA was not increased in SGLT2 inhibitor users vs DPP‐4 inhibitor users (hazard ratio [HR] 0.956, 95% confidence interval [CI] 0.581‐1.572; P = .996). The incidence rate of hospitalization for DKA during the first 30 days after initiation of the SGLT2 inhibitor was 2.501 cases per 1000 person‐years, which was higher than the rate during 3 years (0.614 cases per 1000 person‐years). SGLT2 inhibitor use was associated with a higher HR in patients with diabetic microvascular complications (HR 2.044, 95% CI 0.900‐4.640; P = .088) and in patients taking diuretics (HR 3.648, 95% CI 0.720‐18.480; P = .118), although these associations were not statistically significant.
Conclusion
We found that SGLT2 inhibitor treatment did not increase the risk of DKA compared with DPP‐4 inhibitor treatment. Our findings suggest that patients prescribed diuretics or those with microvascular complications may have a greater tendency to be hospitalized for DKA.</description><identifier>ISSN: 1462-8902</identifier><identifier>EISSN: 1463-1326</identifier><identifier>DOI: 10.1111/dom.13297</identifier><identifier>PMID: 29569427</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; antidiabetic drug ; Antidiabetics ; Cohort analysis ; Cohort Studies ; cohort study ; Diabetes ; diabetes complications ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetic ketoacidosis ; Diabetic Ketoacidosis - chemically induced ; Diabetic Ketoacidosis - epidemiology ; Diabetic Ketoacidosis - prevention & control ; Diabetic Ketoacidosis - therapy ; Dipeptidyl-peptidase IV ; Dipeptidyl-Peptidase IV Inhibitors - adverse effects ; Dipeptidyl-Peptidase IV Inhibitors - therapeutic use ; Diuretics ; DPP‐4 inhibitor ; Female ; Follow-Up Studies ; Glucose transporter ; Hospitalization ; Humans ; Incidence ; Insurance, Health, Reimbursement ; Kaplan-Meier Estimate ; Ketoacidosis ; Male ; Microvasculature ; Middle Aged ; Patients ; Peptidase ; Population studies ; Population-based studies ; Proportional Hazards Models ; Republic of Korea - epidemiology ; Retrospective Studies ; Risk ; SGLT2 inhibitor ; Sodium ; Sodium-Glucose Transporter 2 Inhibitors - adverse effects ; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use ; Statistical analysis ; Young Adult</subject><ispartof>Diabetes, obesity & metabolism, 2018-08, Vol.20 (8), p.1852-1858</ispartof><rights>2018 John Wiley & Sons Ltd</rights><rights>2018 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3537-eed2d4cef5cd281048b86f5843dda96192382ba3958d7d04d659da10a92a5a883</citedby><cites>FETCH-LOGICAL-c3537-eed2d4cef5cd281048b86f5843dda96192382ba3958d7d04d659da10a92a5a883</cites><orcidid>0000-0002-8982-5230 ; 0000-0003-1025-2044 ; 0000-0002-8958-7164</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fdom.13297$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fdom.13297$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,27907,27908,45557,45558</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29569427$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Young‐Gun</creatorcontrib><creatorcontrib>Jeon, Ja Young</creatorcontrib><creatorcontrib>Han, Seung Jin</creatorcontrib><creatorcontrib>Kim, Dae Jung</creatorcontrib><creatorcontrib>Lee, Kwan‐Woo</creatorcontrib><creatorcontrib>Kim, Hae Jin</creatorcontrib><title>Sodium‐glucose co‐transporter‐2 inhibitors and the risk of ketoacidosis in patients with type 2 diabetes mellitus: A nationwide population‐based cohort study</title><title>Diabetes, obesity & metabolism</title><addtitle>Diabetes Obes Metab</addtitle><description>Aims
To estimate the risk of diabetic ketoacidosis (DKA) associated with sodium‐glucose co‐transporter‐2 (SGLT2) inhibitor treatment compared with the risk associated with dipeptidyl‐peptidase‐4 (DPP‐4) inhibitor treatment.
Methods
A nationwide population‐based cohort study using claims data from the Korean Health Insurance Review and Assessment Service from January 1, 2013 to June 30, 2017 was performed. A total of 56 325 patients who were started on SGLT2 inhibitors were included in this study and were matched with same number of patients who were started on DPP‐4 inhibitors using propensity score matching. Kaplan–Meier curves and Cox proportional hazards regression analyses were used to estimate the risk of hospitalization for DKA.
Results
The risk of hospitalization for DKA was not increased in SGLT2 inhibitor users vs DPP‐4 inhibitor users (hazard ratio [HR] 0.956, 95% confidence interval [CI] 0.581‐1.572; P = .996). The incidence rate of hospitalization for DKA during the first 30 days after initiation of the SGLT2 inhibitor was 2.501 cases per 1000 person‐years, which was higher than the rate during 3 years (0.614 cases per 1000 person‐years). SGLT2 inhibitor use was associated with a higher HR in patients with diabetic microvascular complications (HR 2.044, 95% CI 0.900‐4.640; P = .088) and in patients taking diuretics (HR 3.648, 95% CI 0.720‐18.480; P = .118), although these associations were not statistically significant.
Conclusion
We found that SGLT2 inhibitor treatment did not increase the risk of DKA compared with DPP‐4 inhibitor treatment. Our findings suggest that patients prescribed diuretics or those with microvascular complications may have a greater tendency to be hospitalized for DKA.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>antidiabetic drug</subject><subject>Antidiabetics</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>cohort study</subject><subject>Diabetes</subject><subject>diabetes complications</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetic ketoacidosis</subject><subject>Diabetic Ketoacidosis - chemically induced</subject><subject>Diabetic Ketoacidosis - epidemiology</subject><subject>Diabetic Ketoacidosis - prevention & control</subject><subject>Diabetic Ketoacidosis - therapy</subject><subject>Dipeptidyl-peptidase IV</subject><subject>Dipeptidyl-Peptidase IV Inhibitors - adverse effects</subject><subject>Dipeptidyl-Peptidase IV Inhibitors - therapeutic use</subject><subject>Diuretics</subject><subject>DPP‐4 inhibitor</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glucose transporter</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Incidence</subject><subject>Insurance, Health, Reimbursement</subject><subject>Kaplan-Meier Estimate</subject><subject>Ketoacidosis</subject><subject>Male</subject><subject>Microvasculature</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Peptidase</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>Proportional Hazards Models</subject><subject>Republic of Korea - epidemiology</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>SGLT2 inhibitor</subject><subject>Sodium</subject><subject>Sodium-Glucose Transporter 2 Inhibitors - adverse effects</subject><subject>Sodium-Glucose Transporter 2 Inhibitors - therapeutic use</subject><subject>Statistical analysis</subject><subject>Young Adult</subject><issn>1462-8902</issn><issn>1463-1326</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1u1TAQhS0EoqWw4AWQJTZlkdY_cWKzq8qvVNQFsI6ceMJ1m8TBY-vq7ngEXoIX40kw9xYWSMxm5kifzhzpEPKUszNe5tyF-YxLYdp75JjXjayKaO7vb1Fpw8QReYR4wxirpW4fkiNhVGNq0R6THx-D83n--e37lykPAYEOoYgU7YJriAliUYL6ZeN7n0JEahdH0wZo9HhLw0hvIQU7eBfQY-HoapOHJSHd-rShabcCFdR520MCpDNMk08ZX9ILuhQyLFvvgK5hzdNelne9RXAlx6b8p5iy2z0mD0Y7ITy52yfk85vXny7fVVfXb99fXlxVg1SyrQCccPUAoxqc0JzVutfNqHQtnbOm4UZILXorjdKudax2jTLOcmaNsMpqLU_I6cF3jeFrBkzd7HEoke0CIWMnGNdMcNWqgj7_B70JOS4lXaEaLUTLjSzUiwM1xIAYYezW6Gcbdx1n3e_uutJdt--usM_uHHM_g_tL_imrAOcHYOsn2P3fqXt1_eFg-Qti06oA</recordid><startdate>201808</startdate><enddate>201808</enddate><creator>Kim, Young‐Gun</creator><creator>Jeon, Ja Young</creator><creator>Han, Seung Jin</creator><creator>Kim, Dae Jung</creator><creator>Lee, Kwan‐Woo</creator><creator>Kim, Hae Jin</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8982-5230</orcidid><orcidid>https://orcid.org/0000-0003-1025-2044</orcidid><orcidid>https://orcid.org/0000-0002-8958-7164</orcidid></search><sort><creationdate>201808</creationdate><title>Sodium‐glucose co‐transporter‐2 inhibitors and the risk of ketoacidosis in patients with type 2 diabetes mellitus: A nationwide population‐based cohort study</title><author>Kim, Young‐Gun ; Jeon, Ja Young ; Han, Seung Jin ; Kim, Dae Jung ; Lee, Kwan‐Woo ; Kim, Hae Jin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3537-eed2d4cef5cd281048b86f5843dda96192382ba3958d7d04d659da10a92a5a883</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>antidiabetic drug</topic><topic>Antidiabetics</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>cohort study</topic><topic>Diabetes</topic><topic>diabetes complications</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Diabetic ketoacidosis</topic><topic>Diabetic Ketoacidosis - chemically induced</topic><topic>Diabetic Ketoacidosis - epidemiology</topic><topic>Diabetic Ketoacidosis - prevention & control</topic><topic>Diabetic Ketoacidosis - therapy</topic><topic>Dipeptidyl-peptidase IV</topic><topic>Dipeptidyl-Peptidase IV Inhibitors - adverse effects</topic><topic>Dipeptidyl-Peptidase IV Inhibitors - therapeutic use</topic><topic>Diuretics</topic><topic>DPP‐4 inhibitor</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glucose transporter</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Incidence</topic><topic>Insurance, Health, Reimbursement</topic><topic>Kaplan-Meier Estimate</topic><topic>Ketoacidosis</topic><topic>Male</topic><topic>Microvasculature</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Peptidase</topic><topic>Population studies</topic><topic>Population-based studies</topic><topic>Proportional Hazards Models</topic><topic>Republic of Korea - epidemiology</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>SGLT2 inhibitor</topic><topic>Sodium</topic><topic>Sodium-Glucose Transporter 2 Inhibitors - adverse effects</topic><topic>Sodium-Glucose Transporter 2 Inhibitors - therapeutic use</topic><topic>Statistical analysis</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Young‐Gun</creatorcontrib><creatorcontrib>Jeon, Ja Young</creatorcontrib><creatorcontrib>Han, Seung Jin</creatorcontrib><creatorcontrib>Kim, Dae Jung</creatorcontrib><creatorcontrib>Lee, Kwan‐Woo</creatorcontrib><creatorcontrib>Kim, Hae Jin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes, obesity & metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Young‐Gun</au><au>Jeon, Ja Young</au><au>Han, Seung Jin</au><au>Kim, Dae Jung</au><au>Lee, Kwan‐Woo</au><au>Kim, Hae Jin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sodium‐glucose co‐transporter‐2 inhibitors and the risk of ketoacidosis in patients with type 2 diabetes mellitus: A nationwide population‐based cohort study</atitle><jtitle>Diabetes, obesity & metabolism</jtitle><addtitle>Diabetes Obes Metab</addtitle><date>2018-08</date><risdate>2018</risdate><volume>20</volume><issue>8</issue><spage>1852</spage><epage>1858</epage><pages>1852-1858</pages><issn>1462-8902</issn><eissn>1463-1326</eissn><abstract>Aims
To estimate the risk of diabetic ketoacidosis (DKA) associated with sodium‐glucose co‐transporter‐2 (SGLT2) inhibitor treatment compared with the risk associated with dipeptidyl‐peptidase‐4 (DPP‐4) inhibitor treatment.
Methods
A nationwide population‐based cohort study using claims data from the Korean Health Insurance Review and Assessment Service from January 1, 2013 to June 30, 2017 was performed. A total of 56 325 patients who were started on SGLT2 inhibitors were included in this study and were matched with same number of patients who were started on DPP‐4 inhibitors using propensity score matching. Kaplan–Meier curves and Cox proportional hazards regression analyses were used to estimate the risk of hospitalization for DKA.
Results
The risk of hospitalization for DKA was not increased in SGLT2 inhibitor users vs DPP‐4 inhibitor users (hazard ratio [HR] 0.956, 95% confidence interval [CI] 0.581‐1.572; P = .996). The incidence rate of hospitalization for DKA during the first 30 days after initiation of the SGLT2 inhibitor was 2.501 cases per 1000 person‐years, which was higher than the rate during 3 years (0.614 cases per 1000 person‐years). SGLT2 inhibitor use was associated with a higher HR in patients with diabetic microvascular complications (HR 2.044, 95% CI 0.900‐4.640; P = .088) and in patients taking diuretics (HR 3.648, 95% CI 0.720‐18.480; P = .118), although these associations were not statistically significant.
Conclusion
We found that SGLT2 inhibitor treatment did not increase the risk of DKA compared with DPP‐4 inhibitor treatment. Our findings suggest that patients prescribed diuretics or those with microvascular complications may have a greater tendency to be hospitalized for DKA.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>29569427</pmid><doi>10.1111/dom.13297</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-8982-5230</orcidid><orcidid>https://orcid.org/0000-0003-1025-2044</orcidid><orcidid>https://orcid.org/0000-0002-8958-7164</orcidid></addata></record> |
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| issn | 1462-8902 1463-1326 |
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| subjects | Adult Aged Aged, 80 and over antidiabetic drug Antidiabetics Cohort analysis Cohort Studies cohort study Diabetes diabetes complications Diabetes mellitus Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - drug therapy Diabetic ketoacidosis Diabetic Ketoacidosis - chemically induced Diabetic Ketoacidosis - epidemiology Diabetic Ketoacidosis - prevention & control Diabetic Ketoacidosis - therapy Dipeptidyl-peptidase IV Dipeptidyl-Peptidase IV Inhibitors - adverse effects Dipeptidyl-Peptidase IV Inhibitors - therapeutic use Diuretics DPP‐4 inhibitor Female Follow-Up Studies Glucose transporter Hospitalization Humans Incidence Insurance, Health, Reimbursement Kaplan-Meier Estimate Ketoacidosis Male Microvasculature Middle Aged Patients Peptidase Population studies Population-based studies Proportional Hazards Models Republic of Korea - epidemiology Retrospective Studies Risk SGLT2 inhibitor Sodium Sodium-Glucose Transporter 2 Inhibitors - adverse effects Sodium-Glucose Transporter 2 Inhibitors - therapeutic use Statistical analysis Young Adult |
| title | Sodium‐glucose co‐transporter‐2 inhibitors and the risk of ketoacidosis in patients with type 2 diabetes mellitus: A nationwide population‐based cohort study |
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