中国药物警戒 ›› 2025, Vol. 22 ›› Issue (6): 693-695.
DOI: 10.19803/j.1672-8629.20240845

• 安全与合理用药 • 上一篇    下一篇

二甲双胍恩格列净片（Ⅰ）致正常血糖型糖尿病酮症酸中毒1例分析

郑桂梅1, 谢泽宇1, 程筱玲2, 刘江1, 张悦艳1, 曹伟灵1*   

  1. 1深圳市罗湖区人民医院药学部,广东 深圳 518000;
    2深圳市罗湖区人民医院内分泌科,广东 深圳 518000
  • 收稿日期:2024-11-01 发布日期:2025-06-18
  • 通讯作者: *曹伟灵,本科,主任药师,药事管理。E-mail: 752557163@qq.com
  • 作者简介:郑桂梅,女,本科,副主任药师,糖尿病与卫生经济学评价。
  • 基金资助:
    深圳市罗湖区人民医院课题（LCYJ202203）; 深圳市罗湖区科技创新局课题（LX202202112）; 广东省卫生经济学会课题（2024-WJ MF-106）

One Case of Euglycemic Diabetic Ketoacidosis Caused by Metformin Hydrochloride and Empagliflozin Tablets(Ⅰ)

ZHENG Guimei1, XIE Zeyu1, CHENG Xiaoling2, LIU Jiang1, ZHANG Yueyan1, CAO Weiling1*   

  1. 1Department of Pharmacy, Shenzhen Luohu People’s Hospital, Shenzhen Guangdong 518000, China;
    2Department of Endocrinology, Shenzhen Luohu People’s Hospital, Shenzhen Guangdong 518000, China
  • Received:2024-11-01 Published:2025-06-18

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摘要： 目的 探讨恩格列净致正常血糖型糖尿病酮症酸中毒（euDKA）的机制及高危因素,以提高用药安全性。方法 分析1例二甲双胍恩格列净片（I）致euDKA病例,结合文献分析其发病机制。结果 患者血糖正常但出现酮症酸中毒,经停药、补液、胰岛素治疗后病情好转。文献提示euDKA与胰岛素不足有关。结论 恩格列净可能导致euDKA,其症状隐匿,易漏诊,临床需警惕高危患者,加强用药监护,保障患者用药安全。

关键词: 二甲双胍恩格列净片（I）, 正常血糖型糖尿病酮症酸中毒, SGLT2抑制剂, 糖尿病酮症酸中毒, 药品不良反应

Abstract: Objective To explore the mechanisms of and risk factors for empagliflozin-induced euglycemic diabetic ketoacidosis (euDKA) so as to ensure the safety of medication. Methods One case of euDKA induced by metformin hydrochloride and empagliflozin tablets（Ⅰ）was retrospectively analyzed. Related literature was reviewed to find out more about the pathogenesis. Results The patient exhibited ketoacidosis with normal blood glucose levels, but his conditions were improved after discontinuation of the drug, fluid replacement, and insulin therapy. Literature suggested that euDKA was associated with insulin deficiency. Conclusion Empagliflozin may cause euDKA. The symptoms are usually insidious and prone to missed diagnosis. Clinically, high-risk patients deserve more attention. Pharmaceutical care should be enhanced to ensure the safety of patients.

Key words: Metformin Hydrochloride and Empagliflozin Tablets（Ⅰ）, Euglycemic Diabetic Ketoacidosis, SGLT2 Inhibitor, Diabetic Ketoacidosis, Adverse Drug Reaction

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