H. Seki, H. Watanabe and T. Yorozu (2022). Postoperative Ketoacidosis With Hypoglycemia in a Nondiabetic Patient Taking Dapagliflozin for Heart Failure: A Case Report. A&A practice, 16(3), e01570. https://doi.org/10.1213/XAA.0000000000001570

PubMed 35285818

[Abstract]
Sodium-glucose cotransporter 2 (SGLT-2) inhibitors are relatively new antidiabetic drugs, which have been recently approved for heart failure treatment. Although treatment interruption is recommended 3 to 4 days before surgery, it is unclear whether SGLT-2 inhibitors should be discontinued when prescribed for heart failure treatment. We describe a case of postoperative ketoacidosis with hypoglycemia in an 83-year-old woman who took dapagliflozin for heart failure and underwent transcatheter aortic valve replacement. She was nondiabetic and took dapagliflozin on the day of the procedure. This case suggests the need to discontinue SGLT-2 inhibitors ahead of the day of surgery when used for heart failure.