Warning over common heart drug that could trigger life-threatening 'diabetic attack'

A pill taken by more than a million type 2 diabetics could put patients at risk of a deadly organ-wrecking disease, scientists have warned. Medications used to lower blood sugar may trigger a condition called ketoacidosis, otherwise known as a 'diabetic attack'.This happens when levels of harmful compounds called ketones build-up in the blood, triggering a range of life-threatening complications.Swedish researchers found that drugs called SGLT2 inhibitors could trigger the condition, particularly in type 2 diabetics with a low body weight.Around 10 per cent of people with type 2 diabetes have a body mass index that isn't in the overweight or obesity category, according to charity Diabetes UK.Experts have previously suggested that the drugs encourage the body to burn fat for energy, which fuels the release of ketones. The new warning follows separate research showing that deaths from ketoacidosis are on the rise in the UK. Medications used to lower blood sugar may trigger a condition called ketoacidosis, otherwise known as a 'diabetic attack'The new study, which is published in The Lancet Diabetes and Endocrinology journal, suggests the drugs - prescribed to around a third of the UK's type 2 diabetics - may be a trigger for high-risk patients.Scientists from the prestigious Karolinska Institute analysed the health records of 280,000 type 2 diabetes patients treated with SGLT2 inhibitors, such as dapagliflozin.Such drugs help lower blood sugar by increasing the amount of sugar released by the kidneys via urine. Type 2 diabetics have too much sugar in their blood - a result of their body's insensitivity to insulin, which converts sugar in food into energy.The drugs are also prescribed to protect against heart failure, kidney disease, and studies have shown they can even help with weight loss.There are four types of SGLT2 inhibitor available in the UK, which are taken as once-daily tablets.As well as dapagliflozin, which goes by the brand name Forxiga, these include canagliflozin, known as Invokana; empagliflozin, sold as Jardiance; and ertugliflozin, known as Steglatro. Researchers found patients were at greatest risk of ketoacidosis if they had previously suffered the condition, had high blood sugar, were underweight or showed signs of malnutrition.Those with a history of dangerously low blood sugar, known as hypoglycaemia, were also at high risk. Suffering an infection was the most common trigger of ketoacidosis, they said. Meanwhile, kidney problems, stroke and major surgery were also more common among patients who developed it.Crucially, while the risk was highest during the first few months of treatment, researchers said it persisted the whole time patients were taking the drugs. This builds on previous studies, which have mainly examined the risk during the early stages of treatment. 'SGLT2 inhibitors provide medical benefits for many patients,' explains Peter Ueda, assistant professor at the Department of Medicine in the Karolinska Institute. 'Our findings are not primarily about avoiding treatment, but about improving our ability to identify high-risk patients and use these medicines more safely.'The researchers also hope the findings will help doctors decide when treatment should be stopped.They said they now plan to study their findings in more detail and investigate other rare but serious side effects of modern diabetes medicines. Last year researchers from Imperial College London found ketoacidosis cases rose by 81 per cent between 2015 and 2023.The NHS says symptoms of can include feeling thirsty and needing to urinate more often than usual.People may also experience stomach pain, nausea or vomiting, diarrhoea and blurry vision.Other warning signs include unusually deep breathing, fruity-smelling breath and feeling extremely tired, sleepy or confused.