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Cancer

Diabetic Ketoacidosis Risk Factors Identified in Hematologic Malignancy Patients

Strategic Insights

— 1 min read

Researchers from the City of Hope have identified a unique set of risk factors for diabetic ketoacidosis (DKA) in patients with hematologic malignancies, particularly those undergoing high-intensity treatment. The findings highlight the importance of close clinical and laboratory monitoring to facilitate rapid diagnosis and treatment of DKA. According to the study, sodium-glucose cotransporter 2 inhibitors (SGLT2i), commonly used to treat type 2 diabetes and congestive heart failure, may increase the risk of DKA in these patients due to factors such as anorexia, weight loss, and infections.

Key Takeaways:

  • Four cases of empagliflozin-associated euglycemic DKA (EDKA) were identified in hematologic malignancy patients through pharmacy adverse event reporting at a cancer research hospital.
  • All patients experienced weight loss due to reduced oral intake, diarrhea, nausea, and pain, as well as infections and/or neutropenic fever.
  • In all patients, DKA contributed to iatrogenic ICU admissions and prolonged hospital stays.
  • Clinicians should be aware of risk factors for DKA in patients receiving SGLT2i, particularly those undergoing hematologic malignancy treatment.
  • Close clinical and laboratory monitoring is crucial to ensure rapid diagnosis and treatment of DKA in these patients.
  • The safety of empagliflozin in cancer patients is not well established, and its use in hematologic malignancy patients may increase the risk of DKA.

Statistics:

  • 4 cases of empagliflozin-associated EDKA were identified in hematologic malignancy patients.
  • 100% of patients experienced weight loss due to reduced oral intake, diarrhea, nausea, and pain.
  • 100% of patients experienced infections and/or neutropenic fever.
  • 100% of patients experienced iatrogenic ICU admissions due to DKA.
  • 4 patients with hematologic malignancy required treatment with dexamethasone, leading to steroid-induced hyperglycemia.

Sources:

  • City of Hope
  • Advances in Hematology
  • Hindawi (publisher)
  • Journal article: SGLT2 Inhibitor-Associated Euglycemic Diabetic Ketoacidosis (EDKA) in Hematologic Malignancy Patients: A Case Series (Advances in Hematology, 2025)
  • DOI: 10.1155/ah/7244013 (free version available at https://doi-org.sdpl.idm.oclc.org/10.1155/ah/7244013)

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