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Introduction. The introduction of sodium glucose cotransporter 2 inhibitors in the management of diabetes was an innovation in the treatment of this disease, considering the protective cardiovascular effect not only the ability of decreasing the plasma glucose. In Europe, this class of medication is approved for the treatment of type 2 diabetes and some of them (dapagliflozin and sotagliflozin) are also approved for use in certain patients with type 1 diabetes mellitus. These patients must have inadequate control of their blood glucose levels despite optimal insulin therapy. One of the adverse effects is diabetic ketoacidosis. Case report. This case report presents a diabetic patient whose treatment was changed from insulin therapy to oral therapy. Within 10 days after the initiation of the new treatment her condition gradually worsened and she arrived at the emergency room with nausea, vomiting and altered general condition. She was admitted for euglycemic ketoacidosis and treated according to the protocol. Conclusions. This case reveals the importance of continuing the insulin therapy when adding a sodium glucose cotransporter 2 inhibitor in type 1 diabetes patients. [ABSTRACT FROM AUTHOR]

Background & Aims. A point mutation (gp130Y757F/ Y759F) was identified as being responsible for aberrant activation of gp130 in mice and associated with gastric adenocarcinoma induction. As a result, we investigated the possible role of key point mutations in Tyr from IL6ST exon 17 that encode for the catalytic domain of gp130, and of its respective activators (IL-6 family member cytokines) in human gastric cancer initiation and development. Method. DNA, protein and plasma from 51 patients with gastric adenocarcinoma have been used in exploring gp130 status. We used sequencing analysis of IL6ST exon 17 in order to identify possible mutations that would lead to constitutive active forms of the receptor. The levels of gp130 activators (IL-6, IL-11, LIF) were analyzed by ELISA in plasma and mucosa of patients with gastric adenocarcinoma. Results. Sequencing analysis did not identify mutations in gp130 key positions (Y759, Y767, Y814, Y905 and Y915). An increased IL-6 and IL-11 level in gastric mucosa was observed, correlated with staging, indicating these cytokines as gp130 activators in tumor epithelial cell. Those variations were consistent with increased IL-6 level in plasma. Furthermore, IL-6, but not IL-11 showed a significant correlation with patient's survival time, suggesting that tissue and plasma concentration of IL-6 might be a marker of tumor aggressiveness with prognostic value. Conclusions. According to our results, no mutations were detected in gp130 key positions in human gastric adenocarcinoma samples. However, gp130 activation may occur due to the increased level of IL-6 and IL-11 cytokines detected that can become valuable biomarkers. [ABSTRACT FROM AUTHOR]