Abstract
A 71-year-old woman was admitted to our department due to cerebellum and brainstem infarction in May 2014. She had been diagnosed with diabetes mellitus at 40 years of age. Her glycemic control had been poor despite treatment with oral antidiabetic agents, and ipragliflozin (50 mg daily) was added in April. She subsequently became thirsty and consulted our hospital with complaints of dizziness, nausea and vomiting nine days after the initiation of ipragliflozin. Her blood glucose and HbA1c levels were 219 mg/dl and 9.8 %, respectively. The hemoglobin and hematocrit levels were 13.4 g/dl (11.0 g/dl in March) and 40.6 % (35.3 % in March), respectively, indicating dehydration. An ECG showed ischemic changes, with an ankle brachial index of 0.85/0.76 as well as stenosis and occlusion of the bilateral anterior and posterior tibial arteries on ultrasonography. She was discharged after withdrawing ipragliflozin and administering insulin therapy and treatment for cerebral infarction. Her condition was considered to be associated with the onset of cerebral infarction due to her older age, lack of obesity, treatment with diuretic drugs and uncontrolled diabetes. It is desirable to perform screening tests for arteriosclerosis prior to initiating SGLT2 inhibitor therapy.
