A study of clinical characteristics and influence factor of ketosis complicating type 2 diabetes mellitus in elderly patients treated with SGLT-2 inhibitors
REN Shuang
MENG Yinping
LI Wen
ZHANG Liu
SHI Shuyue
LIU Yufang
Abstract：Objective To investigate the clinical characteristics and influencing factor of ketosis complications in elderly patients with type 2 diabetes mellitus treated with sodium-glucose co-transporter protein 2(SGLT-2)inhibitors,and to provide a reference basis for the timely development of clinical preventive countermeasures.Methods The cases of 62 elderly patients with type 2 diabetes who were treated with SGLT-2 inhibitors and developed ketosis from January 2021 to July 2024 in the Baoding Second Central Hospital were selected as the ketosis group,and another 186 patients with type 2 diabetes who were treated with SGLT-2 inhibitors in the same period of time but did not develop ketosis in the same period of time in the hospital were selected as the control group in the 1∶3 ratio.The clinical characteristics of two groups were compared,and the influence factors of ketosis complications in elderly patients with type 2 diabetes mellitus treated with SGLT-2 inhibitor were analyzed by multifactorial Logistic regression.Results The ketosis group had a higher percentage of history of alcohol consumption,stressful events,acute infections,unregulated diet and daily water intake<1500 mL,and higher levels of whole-glucosylated hemoglobin(HbA1c),fasting blood glucose(FPG),and 2 h postprandial glucose(2 h PPG)than the control group(P<0.05),and the levels of whole blood fasting C-peptide(FCP),2 h postprandial C-peptide(2 h CP),and serum 25-hydroxyvitamin D[25(OH)D]were lower than those in the control group(χ2=6.476、10.512、17.205、9.431、19.692,t=10.400、6.626、5.962、15.605、20.812、10.075,P<0.05).The results of multifactorial Logistic regression analysis showed that higher history of alcohol consumption,stressful events,acute infections,the daily water intake<1500 mL,levels of whole blood HbA1c,FCP,FPG,serum 25(OH)D were influence factor for the complication of ketoacidosis in elderly patients with type 2 diabetes mellitus treated with SGLT-2 inhibitors(OR=2.782、2.641、2.754、2.604、1.095、1.093、2.841、2.377,P<0.05).Conclusion Complicated ketosis in elderly patients with type 2 diabetes treated with SGLT-2 inhibitors were associated with a history of alcohol consumption,stressful events,acute infections,daily water intake,levels of glucose metabolism and pancreatic β-cell indices,andserum 25(OH)D.
Keywords：type 2 diabetes mellituselderlysodium-glucose cotransporter protein 2ketosisclinical featuresinfluence factor
Publication Date：2025-10-31
Online Publishing Date：2025-11-17(First online date of this platform, not the publication date of the document)
Pages：4( 828-831 )