Preparedness for DKA among those on an SGLT-2

In light of the FDA's update to the Warnings and Precautions of all approved SGLT-2 inhibitors to include the risk of diabetic ketoacidosis (DKA), we were curious about patients' experience with DKA and ketone testing. The risk of DKA is considered to be manageable, but have patients talked to their doctors about DKA and ketone testing? How confident are patients that they could recognize DKA?

We were particularly struck by the lack of preparedness for DKA among patients with type 2 diabetes, even those taking an SGLT-2.

  • 79% of patients with type 2 diabetes on an SGLT-2 had not talked to their doctor about DKA.
  • 95% had not talked to their doctor about ketone testing.
  • 4% owned a ketone testing kit.
  • Only 19% were very confident that they could recognize the symptoms of DKA.

It is clear that there is much work that needs to be done to increase patient education about DKA and ketone testing and to increase access to ketone testing kits.

If you want to know more, have an opinion about this topic, or have a suggestion for research, let us know!