ArticleCritical care (London, England)2023
Sodium glucose co-transporter-2 inhibitors in intensive care unit patients with type 2 diabetes: a pilot case control study.
Article in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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17 citing papers in PubMed, 23 citations in OpenAlex.
- Effects of dapagliflozin on urinary output, fluid balance, and biochemistry in critically ill patients: a post-hoc secondary analysis of the DEFENDER trial.Critical care (London, England) · 2025Trial
- Timing-dependent renal protection of dapagliflozin in endotoxemic diabetic mice by real-time GFR and biomarkers.Intensive care medicine experimental · 2026Article
- Current practices of SGLT2 inhibitor use and ketone monitoring in intensive care units: A multicentre observational study.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- A review of the effect of SGLT2 inhibitors on clinical and glycemic outcomes in hospitalized patients: data from studies that included patients with diabetes.Hormones (Athens, Greece) · 2026Review
- Association Between Gliflozins Use and Outcomes in Adults with Sepsis: A Multicenter Retrospective Cohort Study Among Veterans.Annals of intensive care · 2026Article
- SGLT2 inhibitors in frailty: a review of current evidence, and clinical recommendations.The British journal of cardiology · 2026Article
- Review
- Diuretics in critically ill patients: a narrative review of their mechanisms and applications.British journal of anaesthesia · 2025Review
- Exploring the impact of glycemic variability on clinical outcomes in critically ill cerebral infarction patients.Diabetology & metabolic syndrome · 2025Article
- How to manage sodium-glucose cotransporter-2 inhibitors in the critically ill patient?Intensive care medicine · 2025Article
- EValuating the Effect of periopeRaTIve empaGliflOzin on cardiac surgery associated acute kidney injury: rationale and design of the VERTIGO study.Clinical kidney journal · 2024Article
- Effects of sodium-glucose transporter-2 inhibition on systemic hemodynamics, renal function, and intra-renal oxygenation in sepsis-associated acute kidney injury.Intensive care medicine experimental · 2024Article
- [Life-threatening euglycemic ketoacidosis under treatment with empagliflozin in cardiac surgery patients: rare isolated case or a frequent problem in the future?]Die Anaesthesiologie · 2024Article
- SGLT2i treatment during AKI and its association with major adverse kidney events.Frontiers in pharmacology · 2024Article
- Timing of SGLT2i initiation after acute myocardial infarction.Cardiovascular diabetology · 2023 · on this mapArticle
- Sodium-glucose co-transporter-2 inhibitors in the intensive care unit setting: do we really need sodium increase, especially in sepsis? Reply.Critical care (London, England) · 2023Article
- Sodium-glucose co-transporter-2 inhibitors in the intensive care unit setting: Do we really need sodium increase, especially in sepsis?Critical care (London, England) · 2023Article
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9 authors at 7 institutions in 5 countries.
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Abstract
backgroundSodium glucose co-transporter-2 (SGLT2) inhibitors improve long-term cardiovascular and renal outcomes in individuals with type 2 diabetes. However, the safety of SGLT2 inhibitors in ICU patients with type 2 diabetes is uncertain. We aimed to perform a pilot study to assess the relationship between empagliflozin therapy and biochemical, and clinical outcomes in such patients.
methodsWe included 18 ICU patients with type 2 diabetes receiving empagliflozin (10 mg daily) and insulin to target glucose range of 10-14 mmol/l according to our liberal glucose control protocol for patients with diabetes (treatment group). Treatment group patients were matched on age, glycated hemoglobin A1c, and ICU duration with 72 ICU patients with type 2 diabetes exposed to the same target glucose range but who did not receive empagliflozin (control group). We compared changes in electrolyte and acid-base parameters, hypoglycemia, ketoacidosis, worsening kidney function, urine culture findings, and hospital mortality between the groups.
resultsMedian (IQR) maximum increase in sodium and chloride levels were 3 (1-10) mmol/l and 3 (2-8) mmol/l in the control group and 9 (3-12) mmol/l and 8 (3-10) mmol/l in the treatment group (P = 0.045 for sodium, P = 0.059 for chloride). We observed no differences in strong ion difference, pH or base excess. Overall, 6% developed hypoglycemia in each group. No patient in the treatment group and one patient in the control group developed ketoacidosis. Worsening kidney function occurred in 18% and 29% of treatment and control group patients, respectively (P = 0.54). Urine cultures were positive in 22% of treatment group patients and 13% of control group patients (P = 0.28). Overall, 17% of treatment group patients and 19% of control group patients died in hospital (P = 0.79).
conclusionsIn our pilot study of ICU patients with type 2 diabetes, empagliflozin therapy was associated with increases in sodium and chloride levels but was not significantly associated with acid-base changes, hypoglycemia, ketoacidosis, worsening kidney function, bacteriuria, or mortality.
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