Novel anti-diabetic agents named gliflozins were found to mask a dangerous complication called ketoacidosis at the time of surgery. Blood test has to be done to check ketoacidosis in which there is lethal build-up of acid in the blood. A study published in the British Journal of Anaesthesia found 42 cases of people with diabetes who presented for various surgeries, while taking gliflozin medications, experienced ketoacidosis while their blood sugar level was normal.
‘Proper vigilance, adequate patient education, testing ketone levels and blood glucose through home monitoring kits could prevent diabetes-related complications.’
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"Euglycaemic ketoacidosis is deceiving and likely to be missed easily as it presents with near or low-normal blood sugars," says Dr Venkatesan Thiru, Senior Clinical Lecturer, the University of Adelaide. Read More..
"Gliflozin medications are being increasingly used to protect people against heart and kidneys diseases. They work in the kidneys to excrete excess sugar in diabetic patients' urine.
"The condition may happen in the lead-up to surgery when patients cannot eat and drink normally.
"It is difficult to recognize euglycaemic ketoacidosis as blood sugar levels are usually normal."
Diabetic ketoacidosis is a serious complication when the body does not have enough insulin and can't use sugar to generate energy. Instead, the body uses fat to produce energy and this process leads to accumulation of acids called ketones in the body. Blood sugar levels are always high with this ketone build-up which is called diabetic ketoacidosis. If this problem is not treated, it can lead to coma and death. It is likely to happen with severe infection, loss of hydration, illness or during surgery.
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"Failure to identify and treat this condition can result in unnecessary tests looking for other medical and surgical problems after surgery.
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"Patients who undertake weight reduction surgery when they are on a special diet program are at an increased risk of experiencing this complication.
"Extra vigilance is the key in reducing this complication and patients should be educated about this. Care givers should ask for acid load to be tested by checking for blood ketone levels. The good news is that some of the latest blood glucose home monitoring kits can also test for acid build up.
"While the rate of this incident occurring in diabetic patients having surgery is unknown at this stage, our team is embarking on a study to assess the ongoing risk," says Dr Thiru.
Source-Eurekalert