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Any additional factor resulting in decreased carbohydrate intake (e.g., sickness, vomiting or fasting), lowering of insulin levels or doses10 (e.g., missed insulin) or increased insulin demand (e.g., stress or infection) can further increase the risk of DKA in the context of SGLT-2 inhibition.7 Sodium-glucose co-transporter 2 inhibitors and diabetic ketoacidosis Few reports of DKA associated with SGLT-2 inhibitors in children exist

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