ABSTRACT
La cetoacidosis diabética euglucémica es un posible efecto adverso de los inhibidores selectivos del cotransportador sodio-glucosa 2 (isGLT2) en pacientes con diabetes. Por otro lado, recientemente, las principales sociedades científicas han recomendado para el tratamiento de la diabetes dietas bajas o muy bajas en hidratos de carbono, que se han relacionado con la aparición de cetosis. La combinación del tratamiento con estos fármacos y el seguimiento de este tipo de dieta puede ser peligrosa. Presentamos el caso de un paciente de 64 años afecto de diabetes de tipo LADA, en tratamiento habitual con insulinoterapia intensiva en 4 dosis, quien, tras iniciar empagliflocina y una dieta muy baja en hidratos de carbono, en pocos días presentó una descompensación cetoacidótica euglucémica severa
Euglycaemic diabetic ketoacidosis is a possible adverse effect of selective sodium-glucose cotransporter inhibitors 2 (isGLT2) in patients with diabetes. However, the main scientific societies have recently recommended low or very low carbohydrate diets for the treatment of diabetes, relating the latter with the onset of ketosis. The combination of treatment with these drugs and following this type of diet can be dangerous. We present the case of a 64-year-old patient, suffering from LADA type diabetes, under usual treatment with intensive insulin therapy in 4 doses, who a few days after starting empagliflocin and a very low carbohydrate diet presented severe euglycaemic ketoacidotic decompensation
Subject(s)
Humans , Male , Middle Aged , Diet, Ketogenic/methods , Diabetic Ketoacidosis/complications , Sodium-Glucose Transporter 2 Inhibitors/administration & dosage , Latent Autoimmune Diabetes in Adults/diet therapy , Diet, Ketogenic/adverse effects , Societies, Medical/standards , Insulin/therapeutic use , Diabetes Mellitus, Type 1/drug therapyABSTRACT
Euglycaemic diabetic ketoacidosis is a possible adverse effect of selective sodium-glucose cotransporter inhibitors 2 (isGLT2) in patients with diabetes. However, the main scientific societies have recently recommended low or very low carbohydrate diets for the treatment of diabetes, relating the latter with the onset of ketosis. The combination of treatment with these drugs and following this type of diet can be dangerous. We present the case of a 64-year-old patient, suffering from LADA type diabetes, under usual treatment with intensive insulin therapy in 4 doses, who a few days after starting empagliflocin and a very low carbohydrate diet presented severe euglycaemic ketoacidotic decompensation.
Subject(s)
Diabetic Ketoacidosis/etiology , Diet, Ketogenic/adverse effects , Hypoglycemic Agents/adverse effects , Latent Autoimmune Diabetes in Adults/complications , Benzhydryl Compounds/administration & dosage , Benzhydryl Compounds/adverse effects , Glucosides/administration & dosage , Glucosides/adverse effects , Humans , Hypoglycemic Agents/administration & dosage , Insulin/administration & dosage , Insulin/adverse effects , Latent Autoimmune Diabetes in Adults/therapy , Male , Middle Aged , Sodium-Glucose Transporter 2 Inhibitors/administration & dosage , Sodium-Glucose Transporter 2 Inhibitors/adverse effectsABSTRACT
The effects of angiotensin II (ANG II) microinjected unilaterally (left or right) and bilaterally (left and right) at a dose of 0.5 microg (0.5 nmol) into the CA1 hippocampal area of male Sprague Dowley rats on learning and memory (shuttle box) were studied. Bilateral microinjections of ANG II improved learning, i.e. increased the number of avoidances during the two training days as compared to the respective controls microinjected with saline. ANG II facilitated learning and memory, especially when microinjected into the left CA1 hippocampal area as compared to the respective controls microinjected with saline. Left-side microinjection of ANG II increased the number of avoidances on the first and second training day as compared to the right-side microinjection of ANG II. These findings suggest asymmetric effects of ANG II on cognitive processes in hippocampus.
