ABSTRACT
Objective To strengthen nursing awareness and attention,and improve the quality of medication and nursing care,Meta-analysis was used to evaluate the occurrence of sodium-glucose transporter 2 inhibitor related ketoacidosis.Methods Relevant randomized controlled trials were searched in 6 databases,such as CNKI,PubMed,Embase,and the Clinical trial platform,and the literature was screened based on inclusion and exclusion criteria.The search time was from the establishment of databases to January 2023.Revman 5.4.1 was used for quality evaluation and Meta-analysis.Results 24 randomized controlled trials were included.The Meta-analysis results showed that sodium-glucose transporter 2 inhibitors increased the incidence of ketoacidosis(RR=2.52,95％CI[1.82,3.49],P＜0.001).Subgroup analysis showed that the sodium-glucose transporter 2 inhibitors increased the incidence of ketoacidosis in patients with type 2 diabetes(RR=2.42,95％CI[1.70,3.43],P＜0.001),cardiovascular disease(RR=2.32,95％CI[1.59,3.39],P＜0.001),and chronic kidney disease(RR=2.82,95％CI[1.73,4.58],P＜0.001).Cargliflozin(RR=3.21,95％CI[1.43,7.18],P=0.005),Daggliflozin(RR=2.73,95％CI[1.51,4.93],P＜0.001),and Sogliflozin(RR=1.92,95％CI[1.06,3.50],P=0.030)increased the incidence of ketoacidosis,while Engliflozin(RR=1.80,95％CI[0.79,4.11],P=0.160)did not have a significant effect.When the eGFR of patients≤60(mUmin/1.73m2)(RR=2.74,95％CI[1.63,4.60],P＜0.001),the duration of medication≤ 12 month(RR=3.31,95％CI[1.79,6.12],P＜0.001),or the duration of medication＞12 month(RR=2.19,95％CI[1.23,3.91],P=0.008),the sodium-glucose transporter 2 inhibitors increased the occurrence of ketoacidosis.Conclusion For patients receiving sodium-glucose transporter 2 inhibitors treatment regardless of whether they are complicated with diabetes,especially those with heart and kidney diseases,in the early and middle stages of medication,with eGFR ≤60 ml/(min·1.73m2),and those with other susceptibility factors,we should strengthen the observation of patients'medication,optimize medication care,and early identify and intervene in the occurrence of ketoacidosis.