DOI: 10.36347/sjmcr.2017.v05i10.013

Pages: 646-647

The patient was a 56-year-old woman with schizophrenia and diabetes mellitus who had been prescribed risperidone and an SGLT2 inhibitor. The patient’s son found her in her home in an unconscious state after two days of fever. On arrival, her Glasgow Coma Scale score was E3V4M6. She had a blood pressure of 144/122 mmHg, a heart rate of 163 beats per minute (BPM), a respiratory rate of 22 breaths per minute, and a body temperature of 41.1°C. She was diagnosed with urosepsis with hyperglycemia, glucosuria and dehydration a massive infusion of lactate Ringer solution was administered. As a result, her heart rate decreased to 102 BPM and her consciousness improved. After admission to the intensive-care unit, she underwent intermittent antibiotic treatment and received a continuous infusion of insulin without an SGLT2 inhibitor to control her blood glucose level to <200 mg/dl. However, her urinary glucose level remained at 4+, and her urinary volume increased to >3000 ml per day with a gradual increase in hypernatremia and heart rate, she also developed a consciousness disturbance; this required aggressive fluid resuscitation. From the 5th day, her urinary volume decreased gradually. After obtaining a normal daily urinary volume with normal vital signs, and the improvement of her urinary tract infection, she was discharged on foot. We reported the first case of diabetes insipidus induced by an SGLT2 inhibitor. Physicians should consider the possible development of diabetes insipidus when treating patients using SGLT2 inhibitors.