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Case Reports
. 2022 Mar 18:13:840580.
doi: 10.3389/fendo.2022.840580. eCollection 2022.

A Case Series of Ketoacidosis After Coronavirus Disease 2019 Vaccination in Patients With Type 1 Diabetes

Fumiyoshi Yakou  1 , Masuo Saburi  1 , Ai Hirose  1 , Hiroaki Akaoka  1 , Yusuke Hirota  1 , Takaaki Kobayashi  1 , Naoko Awane  1 , Nobuteru Asahi  1 , Toshihiro Amagawa  1 , Sachihiko Ozawa  2 , Atsushi Ohno  1 , Takaya Matsushita  1
Affiliations
Case Reports

A Case Series of Ketoacidosis After Coronavirus Disease 2019 Vaccination in Patients With Type 1 Diabetes

Fumiyoshi Yakou et al. Front Endocrinol (Lausanne). .

Abstract

Introduction: We report a case series of severe ketoacidosis after COVID-19 vaccination in a type 1 diabetes patients treated with insulin and an SGLT-2 inhibitor.

Case report: We present two cases of type 1 diabetes mellitus. One patient was treated with insulin therapy and an SGLT-2 inhibitor, and the other patient was treated with insulin therapy alone. Both patients became ill after coronavirus disease-2019 vaccination, making it difficult to continue their diet or insulin injections. On admission, they developed severe diabetic ketoacidosis. This is the first report of ketoacidosis after coronavirus disease-2019 vaccination.

Conclusion: The vaccine should be carefully administered to type 1 diabetes patients receiving intensive insulin therapy and a sodium-glucose transporter due to the high risk ketoacidosis. It is important to instruct patients to drink sufficient fluids and to continue insulin injections when they become sick.

Keywords: clinical diabetes; coronavirus disease 2019 vaccination; ketoacidosis; latent autoimmune diabetes in adults; sodium-glucose cotransporter 2 inhibitor; type 1 diabetes.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The course in day1-2 in a patient with ketoacidosis who was treated with insulin and SGLT2 inhibitor. PG, plasma glucose.
Figure 2
Figure 2
The course in day1-2 in a patient with ketoacidosis who was treated with insulin. PG, plasma glucose.
See this image and copyright information in PMC

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