SAT-523 Patient Education Reduces Rates Of Dka For Populations On Sglt2i

Abstract Disclosure: J.A. Hoyt: None. E.S. Gross: None. L. Au: None. P. Imas: None. R.J. Block: Founder: Vous Vitamins LLC. Introduction: Sodium-Glucose-Cotransporter-2 inhibitors (SGLT2i) limit glucose reabsorption in the convoluted tubule of the nephron to increase glucose excretion and consequentially promote glycemia. However, diabetic ketoacidosis (DKA) is a documented risk associated with SGLT2i use, and higher prescription rates have correlated with increased frequency of DKA in NorthShore/Endeavor hospitals. Since DKA is a physiologic process of dehydration, the diuretic effect of SGLT2i during times of acute illness can precipitate DKA. Hypothesis: We hypothesized that an education program targeting SGLT2i therapy cessation during high-risk situations such as acute illness and surgery could reduce rates of DKA seen in the NorthShore/Endeavor Health hospital system. Methods: To test this hypothesis, quality improvement measures including the creation of standardized care instructions for patients and providers were implemented and the rates of DKA seen among patients actively taking an SGLT2 were compared over the year prior to intervention implementation (2021) and the year following intervention implementation (2022). Chi-squared tests were used to compare differences in DKA prevalence and prescription rates among different specialties between pre- and post-intervention periods. Results: Rates of DKA decreased from pre-intervention rates of 2.7% of patients on SGLT2i to 2.0% of patients on SGLT2 post intervention (p=0.02). Among those with Type 2 Diabetes Mellitus, DKA rates fell from 39.7% pre-intervention to 33.9% post-intervention (p<0.001). Prescription rates from endocrinology (26.1% vs. 22.7%, p<0.001) and internal medicine (40.1% vs. 35.9% p<0.001) departments decreased while prescription rates from nephrology (0.3% vs. 1.2%, p<0.001) and cardiology (10.8% vs. 19.4%, p<0.001) increased. Conclusion: These data support that education remains a critical component of providing adequate care and highlight the success of our implemented education initiatives. Further, these results highlight the importance of tailored patient education on when to withhold SGLT2s, particularly for vulnerable groups. Presentation: Saturday, July 12, 2025