Body mass index is inversely associated with capillary ketones at the time of colonoscopy: Implications for SGLT2i use.
Clin Endocrinol (Oxf)
; 96(4): 549-557, 2022 04.
Article
de En
| MEDLINE
| ID: mdl-34697809
ABSTRACT
OBJECTIVE:
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have been associated with diabetic ketoacidosis at the time of colonoscopy. This study aimed to identify factors associated with ketone concentrations in SGLT2i-treated type 2 diabetes compared with non-SGLT2i-treated diabetes, and those with impaired fasting glycaemia (IFG) and normoglycaemia.DESIGN:
Cross-sectional, multicentre, observational study June-December 2020 in four Australian tertiary hospitals.PARTICIPANTS:
Capillary glucose and ketones were measured in people undergoing colonoscopy 37 SGLT2i-treated and 105 non-SGLT2i-treated type 2 diabetes, 65 IFG and 151 normoglycaemia. MEASUREMENTS Body mass index (BMI), age, glucose, fasting duration and where relevant, HbA1c and time since last SGLT2i dose.RESULTS:
In SGLT2i-treated diabetes, BMI (ρ = -0.43 [95% confidence interval -0.67, -0.11]) and duration since last SGLT2i dose (ρ = -0.33 [-0.60, 0.00]) correlated negatively with increasing ketones, but there was no correlation with fasting duration. In non-SGLT2i-treated diabetes, BMI correlated negatively (ρ = -0.24 [-0.42, -0.05]) and fasting duration positively (ρ = 0.26 [0.07, 0.43]) with ketones. In IFG participants, only fasting duration correlated with ketones (ρ = 0.28 [0.03, 0.49]). In normoglycaemic participants, there were negative correlations with BMI (ρ = -0.20 [-0.35, -0.04]) and fasting glucose (ρ = -0.31 [-0.45, -0.15]) and positive correlations with fasting duration (ρ = 0.20 [0.04, 0.35]) and age (ρ = 0.19 [0.03, 0.34]). Multiple regression analysis of the entire cohort showed BMI, age and fasting glucose remained independently associated with ketones, but in SGLT2i-treated participants only BMI remained independently associated.CONCLUSIONS:
In SGLT2i-treated diabetes, lower BMI was a novel risk factor for higher ketones precolonoscopy. Pending larger confirmatory studies, extra vigilance for ketoacidosis is warranted in these people.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
État prédiabétique
/
Diabète de type 2
/
Inhibiteurs du cotransporteur sodium-glucose de type 2
Type d'étude:
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limites:
Humans
Pays/Région comme sujet:
Oceania
Langue:
En
Journal:
Clin Endocrinol (Oxf)
Année:
2022
Type de document:
Article
Pays d'affiliation:
Australie