Diabetic ketoacidosis (DKA) is a dangerous medical condition that can affect anyone with diabetes, but is rare in type 2 diabetes. In DKA, acids build up in your blood. It can lead to diabetic coma and death. Invokana (canagliflozin) is in a class of drugs called sodium-glucose cotransporter-2 (SGLT2) inhibitors, used to treat type 2 diabetes. SGLT2 inhibitors have been linked to the development of DKA.
DKA occurs when your body cannot use sugar (glucose) for energy. This typically happens when insulin is too low. When glucose cannot be used, your body turns to burning fat for fuel. Ketones are a byproduct of this breakdown of fat. As ketones build up in your blood it becomes acidic.
Early symptoms of DKA include:
- Dry mouth
- Frequent urination
More advanced symptoms include:
- Abdominal pain
- Difficulty breathing
- Deep, rapid breathing
- Difficulty paying attention
- Unusual fatigue, sleepiness, or decreased alertness
- Fruity-smelling breath
- Dry or flushed skin
- Muscle aches or stiffness
DKA is a dangerous medical condition, and it can become fatal. If you experience symptoms of DKA you should talk to your doctor right away or seek emergency medical care.
DKA in People Taking Diabetes Medication
SGLT2 inhibitors are a new class of drugs used to treat type 2 diabetes by causing the kidneys to remove more sugar from the blood. They have been linked to DKA in people with type 2 diabetes. In reported cases of DKA in people taking SGLT2 inhibitors, blood sugar was only mildly elevated. Normally, in DKA, blood sugar is significantly elevated.
Examples of SGLT2 inhibitors include:
- Invokana (canagliflozin)
- Farxiga (dapagliflozin)
- Jardiance (empagliflozin)