A Woman With Type 2 Diabetes Mellitus and Lung Adenocarcinoma Who Developed Diabetic Ketoacidosis after Concomitant Use of Anamorelin and SGLT2 Inhibitor: A Case Report

DOI
  • Sato Fumiya
    Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine
  • Sato Junko
    Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine
  • Yamasaki Nozomu
    Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine
  • Sugawara Yukiko
    Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine
  • Funayama Takashi
    Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine
  • Goto Hiromasa
    Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine
  • Watada Hirotaka
    Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine

Bibliographic Information

Other Title
  • アナモレリンとSGLT2阻害薬の併用により，糖尿病性ケトアシドーシスに至った担癌2型糖尿病女性の1例
Published
2024-06-30
DOI
  • 10.11213/tonyobyo.67.252
Publisher
THE JAPAN DIABETES SOCIETY

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Description

<p>A 68-year-old woman diagnosed with lung adenocarcinoma and brain metastases underwent chemotherapy. She also had type 2 diabetes for approximately eight years, but her HbA1c level was controlled at approximately 7 % without drug therapy. Later, when dexamethasone was added to her chemotherapy regimen, her glycemic control deteriorated, and sitagliptin was started. She also developed cancer cachexia and began treatment with anamorelin hydrochloride, which has ghrelin effects. Thirteen days later, ipragliflozin was started because of elevated blood glucose levels, and four days later, the patient was urgently admitted due to diabetic ketoacidosis (DKA). After hospitalization, the patient discontinued oral medication, and DKA improved with insulin therapy. In this case, the combination of anamorelin hydrochloride and sodium glucose cotransporter (SGLT) 2 inhibitors during chemotherapy with dexamethasone was considered to be the cause of DKA. It is necessary to warn that a combination of these drugs in the terminal stage of cancer may lead to the development of DKA.</p>

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