相关实验视频
Updated: Apr 30, 2026

12:08
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
19.3K
与SGLT2抑制剂和每周GLP-1激动剂相关的优糖性糖尿病酸症的新演示:案例报告
1Department of Endocrinology and Metabolism, Chosun University Hospital, School of Medicine, Chosun University, Gwangju 61452, Republic of Korea.
Healthcare (Basel, Switzerland)
|September 13, 2025
概括
-葡萄糖共运输体-2 (SGLT2) 抑制剂和类似葡萄糖类-1受体激动剂 (GLP-1RAs) 可能会增加患euglycemic糖尿病酸性酸症 (euDKA) 的风险. 这种状况,以正常葡萄糖的症和酸化为标志,需要在患有禁食或胃肠道症状的患者迅速识别.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 内部医学 内部医学
背景情况:
- -葡萄糖共运输体-2 (SGLT2) 抑制剂对于管理2型糖尿病 (T2DM) 至关重要,提供降血糖和心脏保护的好处.
- 优糖性糖尿病酸性酸症 (euDKA) 是一种与SGLT2抑制剂相关的罕见但严重的不良事件,其特征是症和酸性酸症,只有轻微的高血糖症.
- 同时使用类似葡萄糖-1受体激动剂 (GLP-1RAs) 可能会增加eudka的风险,特别是在减少热量摄入或胃肠道困扰的情况下.
研究的目的:
- 在患者同时使用SGLT2抑制剂和GLP-1RA时报告eudka病例.
- 为了强调诊断挑战和在这个患者群体中识别eudka的临床重要性.
- 突出SGLT2抑制剂,GLP-1RA和禁食或胃肠道症状等因素之间的潜在相互作用.
主要方法:
- 一份病例报告详细介绍了一名38岁的新诊断T2DM的妇女,出现了暗示DKA的症状.
- 对患者的药物 anamnesis 的审查,包括最近开始的semaglutide (GLP-1RA) 和enavogliflozin (SGLT2 抑制剂),以及metformin.
- 分析实验室检测结果,包括葡萄糖,,乳酸盐,HbA1c,C-和酸状态,以诊断eudka.
主要成果:
- 患者表现为疲劳,口服不良,恶心和吐,以及轻度高血糖症 (137 mg/dL).
- 实验室结果证实了高阴离子间隙代谢酸症,症 (尿+++) 和乳酸水平升高 (4.87 mg/dL).
- 确立了eudka的诊断,患者对静脉注射液体,胰岛素输注,乳糖和补充剂的反应良好.
结论:
- 这一案例强调了临床医生在使用SGLT2抑制剂和GLP-1RAs的患者中怀疑和诊断eudka的关键需要,特别是那些患有禁食或胃肠道症状的患者.
- 即使没有显著的高血糖症,迅速识别eudka对于及时管理和预防严重并发症至关重要.
- 这些发现强调了在管理T2DM与这些新药疗法时考虑药物相互作用和患者特异性因素的重要性.
相关概念视频
Oral Hypoglycemic Agents: Glinides
1.0K
Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
1.0K
Oral Hypoglycemic Agents: α-Glucosidase Inhibitors
953
α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are...
Acarbose and miglitol are...
953
Glucagon-like Receptor Agonists
1.3K
Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
1.3K
Hypoglycemia and Glucagon
1.3K
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
1.3K
Hyperglycemia
25
Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose...
25
Hyperosmolar Hyperglycemic State
20
Hyperosmolar Hyperglycemic State, or HHS, is a serious and life-threatening complication of type 2 diabetes mellitus. It is characterized by three main features: severe hyperglycemia, profound dehydration, and elevated serum osmolality, all occurring without significant ketoacidosis.HHS typically develops in older adults or individuals with limited access to fluids. This may result from illness, cognitive impairment, or medications such as diuretics or corticosteroids. These factors reduce...
20

