A pill taken by more than a million type 2 diabetics could put patients at risk of a fatal organ-destroying disease, scientists have warned.
Medications used to lower blood sugar levels can cause a condition called ketoacidosis, also known as a “diabetic attack.”
This happens when levels of harmful compounds called ketones build up in the blood, causing a range of life-threatening complications.
Swedish researchers found that drugs called SGLT2 inhibitors can cause the condition, especially in type 2 diabetics with low body weight.
According to the charity Diabetes UK, around 10 percent of people with type 2 diabetes have a body mass index that does not fall into the overweight or obese category.
Experts have previously suggested that the drugs encourage the body to burn fat for energy, which stimulates the release of ketones.
The new warning follows separate research showing that deaths from ketoacidosis are increasing in Britain.
Medications used to lower blood sugar levels can cause a condition called ketoacidosis, also known as a “diabetic attack.”
The new study, published in The Lancet Diabetes and the journal Endocrinology suggest the drugs – which are prescribed to around a third of UK type 2 diabetics – could be a trigger for high-risk patients.
Scientists from the prestigious Karolinska Institute analyzed the health records of 280,000 patients with type 2 diabetes treated with SGLT2 inhibitors, such as dapagliflozin.
Such medications help lower blood sugar levels by increasing the amount of sugar released from the kidneys through the urine.
Type 2 diabetics have too much sugar in their blood – a result of their body’s insensitivity to insulin, which converts sugar in food into energy.
The drugs are also prescribed to protect against heart failure and kidney disease, and research has shown that they can even help with weight loss.
There are four types of SGLT2 inhibitors available in the UK, which are taken as once-daily tablets.
In addition to dapagliflozin, which goes by the brand name Forxiga, these also include canagliflozin, known as Invokana; empagliflozin, sold as Jardiance; and ertugliflozin, known as Steglatro.
Researchers found that patients were at greatest risk for ketoacidosis if they had previously suffered from the condition, had high blood sugar levels, were underweight or showed signs of malnutrition.
Those with a history of dangerously low blood sugar levels, known as hypoglycemia, were also at high risk.
Suffering from an infection was the most common cause of ketoacidosis, they said.
Meanwhile, kidney problems, strokes and major surgeries also became more common in patients who developed this disease.
Crucially, although the risk was highest during the first few months of treatment, researchers said the risk persisted throughout the time patients took the drugs.
This builds on previous studies, which mainly examined the risk during the early stages of treatment.
“SGLT2 inhibitors offer medical benefits for many patients,” explains Peter Ueda, assistant professor at the Karolinska Institute’s Department of Medicine.
‘Our findings are not primarily about avoiding treatment, but about improving our ability to identify high-risk patients and use these drugs more safely.’
The researchers also hope the findings will help doctors decide when to stop treatment.
They said they now plan to study their findings in more detail and investigate other rare but serious side effects of modern diabetes drugs.
Last year, researchers from Imperial College London found that the number of cases of ketoacidosis had increased by 81 percent between 2015 and 2023.
The NHS says symptoms of this can include feeling thirsty and having to urinate more often than normal.
People may also experience stomach pain, nausea or vomiting, diarrhea and blurred vision.
Other warning signs include unusually deep breathing, fruity-smelling breath, and feeling extremely tired, sleepy, or confused.
