Abstract：Sodium-glucose transporter 2 inhibitors (SGLT2i) are novel oral hypoglycemic agents, which reduces blood glucose by inhibiting the reabsorption of glucose in the proximal convoluted tubule of the kidney and increasing the excretion of glucose to the urine. SGLT2i is effective in the treatment for diabetes mellitus, but there are also some safety problems. Diabetic ketoacidosis (DKA) is a serious adverse reaction of SGLT2i. SGLT2i could cause at least a 7-fold increase in developing DKA, approximately 70% of which are euglycemic DKA (euDKA). The risk factors for euDKA include insufficient insulin secretion cell reserve, type 1 diabetes mellitus, insulin reduction or discontinuation, hypovolemia, perioperative period, weight loss, and restricted feeding, etc. Because the increase of blood glucose in patients with euDKA is not obvious, the diagnosis is often delayed, so close attention should be paid to it. Safety medication training for SGLT2i should be strengthened to improve clinicians′ understanding of SGLT2i-related euDKA, so that they can strictly grasp the indications of medication and avoid the inducement of euDKA. Once euDKA occurs, clinicians can make early diagnosis and treatment. Pharmacists should be involved in the safety management of patients using SGLT2i to improve the safety in treatment.
