钠-葡萄糖共转运蛋白2抑制剂引发糖尿病酮症酸中毒机制的研究进展

糖尿病酮症酸中毒是一种以高血糖,酸中毒和酮血症为特征的复杂无序的代谢状态,通常在绝对或相对胰岛素缺乏伴拮抗激素增多时发生。糖尿病酮症酸中毒虽然可预防,但仍是糖尿病患者常见且可能危及生命的并发症。钠-葡萄糖共转运蛋白2抑制剂是一类新型的口服降糖药物,它们通过减少肾脏近端小管葡萄糖的重吸收,增加尿糖排泄来达到降低血糖水平的目的。这类药物使血清中酮酸以及胰高血糖素的产生增加,在某些个体中可导致糖尿病酮症酸中毒的发生。本文将对钠-葡萄糖共转运蛋白2抑制剂可能引发糖尿病酮症酸中毒的潜在机制进行综述,为降低其用药风险提供依据。

Advances in mechanisms of diabetic ketoacidosis induced by SGLT2 inhibitors

Diabetic ketoacidosis is a complex disordered metabolic state characterized by hyperglycaemia, acidosis, and ketonaemia. It usually occurs as a result of absolute or relative insulin deficiency which is accompanied by an increase in counter regulatory hormones. Diabetic ketoacidosis, though preventable, remains a frequent and life-threatening complication of diabetes mellitus. Sodium-glucose cotransporter 2 inhibitors are a new class of oral antihyperglycemic drugs which can inhibit glucose reabsorption in the proximal tubules of the kidney, thereby enhancing glucosuria and lowering blood glucose levels. These drugs increase serum ketoacids and glucagon production, which can lead to diabetic ketoacidosis in some individuals. Here we review the potential mechanisms which SGLT2 inhibitors may facilitate the development of diabetic ketoacidosis to provide the basis for lowering the risk of using these drugs.