# EMA to review diabetes drugs after cases of ketoacidosis



## Northerner (May 26, 2015)

A spate of cases of acidosis that sparked a warning in the United States has prompted the European Medicines Agency (EMA) to review incidences of potentially life-threatening ketoacidosis linked to drugs used to treat type II diabetes. 

The EMA is looking for any reported cases of the condition in patients using sodium-glucose contransporter-2 (SGLT2) inhibitors. 

The review will focus on dapagliflozin (Forxiga), canagliflozin (Invokana), empagliflozin (Jardiance), canagliflozin/metformin (Vokanamet) and dapagliflozin/metformin (Xigduo). These do not currently have a side effect warning about ketoacidosis, which occurs when the body produces high levels of blood acids or ketones. 

Diabetic ketoacidosis (DKA) usually develops when insulin levels are too low or during prolonged fasting. The cases reported to the FDA were not typical DKA because blood sugar levels in the patients were only slightly increased compared to typical DKA. 

http://www.pharmaceutical-journal.c...-after-cases-of-ketoacidosis/20068604.article


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## KookyCat (May 26, 2015)

I do not comprehend, are they saying Metformin and other drugs can cause a sort of malnutrition that triggers ketoacidosis?  I know some people are particularly prone to acidosis during ketogenic processes but how do the drugs cause the problem.  Is it because they prevent carbohydrate utilisation, and thus encourage metabolism of fat stores (which is how they promote weight loss)?  I'm more befuddled now than when I started typing so the obvious answer is to stop.


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## trophywench (May 26, 2015)

It's not the straight Metformin at all - it's only if it's got sglT2 added to it,

No idea what they actually do or how they do it though - because on a need to know basis - I have no need to know!


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