Respiratory physician Lutz Beckert considers chronic obstructive pulmonary disease management, including the prevention of COPD, the importance of smoking cessation and pulmonary rehabilitation, and the lifesaving potential of addressing treatable traits. He also discusses the logic of inhaler therapy, moving from single therapy to dual and triple therapy when indicated, as well as other aspects of management
‘Flozins’ reduce diabetes complications, but beware of euglycaemic ketoacidosis
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In print
PHARMACOTHERAPY
‘Flozins’ reduce diabetes complications, but beware of euglycaemic ketoacidosis
Wednesday 3 February 2021, 12:15 AM

Consuming a diet very low in carbohydrates is a risk factor for euglycaemic ketoacidosis while taking a flozin [Image: Alex Munsell on Unsplash]
The arrival of funded empagliflozin has been eagerly awaited by many. As you start prescribing it to patients meeting Pharmac’s new Special Authority criteria, here’s a hypothetical case study illustrating one possible adverse effect to be aware of
Key points, Sodium-glucose cotransporter-2 inhibitors reduce renal, cardiovascular and heart failure complications of diabetes, while lowering blood glucose level, Pract Green w Pale Yellow
Kia ora and welcome to New Zealand Doctor Rata Aotearoa
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References
- Gomez-Peralta F, Abreu C, Lecube A, et al. Practical approach to initiating SGLT2 inhibitors in type 2 diabetes. Diabetes Ther 2017;8(5):953–62.
- Musso G, Saba F, Cassader M, et al. Diabetes ketoacidosis with SGLT2 inhibitors. BMJ 2020;371:m4147.
- Neuen BL, Young T, Heerspink HJL, et al. SGLT2 inhibitors for the prevention of kidney failure in patients with type 2 diabetes: a systematic review and meta-analysis. Lancet Diabetes Endocrinol 2019;7(11):845–54.
- Yandrapalli S, Aronow WS. Cardiovascular benefits of the newer medications for treating type 2 diabetes mellitus. J Thorac Dis 2017;9(7):2124–34.