Previously submitted to: JMIR Perioperative Medicine (no longer under consideration since Dec 09, 2021)
Date Submitted: Nov 29, 2021
Open Peer Review Period: Nov 29, 2021 - Dec 9, 2021
(closed for review but you can still tweet)
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Medicine Matters: Special Considerations For Sglt2 Inhibitors And Prolonged Nothing Per Os Status Following Free Flap Surgery
ABSTRACT
A 59-year-old female patient undergoing deep inferior epigastric perforator flap surgery for autologous breast reconstruction became acutely ill with tachypnea, nausea, and vomiting on post-operative day three. A work-up elucidated a diagnosis of diabetic ketoacidosis (DKA) with lower-than-expected glucose levels as a result of recent semaglutide use. She required intensive care unit resuscitation with an insulin drip and glucose administration. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are a class of oral anti-hyperglycemic agents used for the treatment of type II diabetes (DMII). As the use of these medications become more prevalent, surgeons must be educated of this serious complication and plan for patient management in advance of minor and major surgeries.
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