Beware ketoacidosis with SGLT2 inhibitors in latent autoimmune diabetes

Sodium-glucose co-transporter-2 (SGLT2) inhibitors are increasingly recommended as second-line agents for the treatment of type 2 diabetes.1 This drug class, through its glycosuric effect, reduces glycated haemoglobin (HbA1c) (mean -0.5%), fasting and postprandial glucose levels. Randomized controlled trials have demonstrated additional benefits in decreasing cardiovascular death in those with established cardiovascular disease;2,3 decreasing hospitalisations for heart failure;2-5 and slowing the progression of diabetic kidney disease.