Sep 13, 2025
1:00 PM2:00 PM
Poster Session
P230
SEVERE MALNUTRITION DUE TO SGLT2 INHIBITOR USE - A CASE REPORT
A. Šuligoj1,*, N. Rotovnik Kozjek1
1Department of Clinical Nutrition, Institute of Oncology Ljubljana, Ljubljana, Slovenia
Rationale: Sodium-Glucose Cotransporter 2 inhibitors (SGLT2 inhibitors) are commonly used to treat type 2 diabetes (T2DM), but their impact on body and muscle mass is not well understood. This study evaluates their effects on body mass and the potential development of sarcopenia in elderly T2DM patients.
Methods: A 69-year-old T2DM patient on SGLT2 inhibitors since 2021 was admitted to the Department of Clinical Nutrition after severe sarcopenia and malnutrition were confirmed. Over 2.5 years, lab tests and weight loss were tracked. Body composition (lean and fat mass) and imaging (dual-energy X-ray absorptiometry - DEXA and bioimpedance) were used to assess muscle and nutritional status after admission (see Figure 1).
Results: The patient lost 17 kg over 2.5 years, mainly from lean body mass. Lab results showed decreased creatinine (11-15 mmol/l) and urinary methylketones (4+), suggesting starvation. During hospitalization for meningoencephalitis (despite full vaccination), ketoacidosis, further weight loss, severe malnutrition, and sarcopenia were confirmed. Parenteral nutrition was started, and refeeding syndrome was managed. Despite these interventions, the patient's condition did not improve, indicating irreversible muscle loss, which led to death.
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Conclusion: SGLT2 inhibitors may cause significant body mass loss, including lean mass, in T2DM patients. Monitoring body composition is crucial to assess their impact on muscle mass. Proper treatment and nutrition support can reduce negative effects, lowering the risk of sarcopenia and related complications, like impaired immune response to vaccination.
Disclosure of Interest: None declared