AUTHOR=Yakou Fumiyoshi , Saburi Masuo , Hirose Ai , Akaoka Hiroaki , Hirota Yusuke , Kobayashi Takaaki , Awane Naoko , Asahi Nobuteru , Amagawa Toshihiro , Ozawa Sachihiko , Ohno Atsushi , Matsushita Takaya TITLE=A Case Series of Ketoacidosis After Coronavirus Disease 2019 Vaccination in Patients With Type 1 Diabetes JOURNAL=Frontiers in Endocrinology VOLUME=13 YEAR=2022 URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.840580 DOI=10.3389/fendo.2022.840580 ISSN=1664-2392 ABSTRACT=Introduction

We report a case series of severe ketoacidosis after COVID-19 vaccination in a type 1 diabetes patients treated with insulin and an SGLT-2 inhibitor.

Case Report

We present two cases of type 1 diabetes mellitus. One patient was treated with insulin therapy and an SGLT-2 inhibitor, and the other patient was treated with insulin therapy alone. Both patients became ill after coronavirus disease-2019 vaccination, making it difficult to continue their diet or insulin injections. On admission, they developed severe diabetic ketoacidosis. This is the first report of ketoacidosis after coronavirus disease-2019 vaccination.

Conclusion

The vaccine should be carefully administered to type 1 diabetes patients receiving intensive insulin therapy and a sodium-glucose transporter due to the high risk ketoacidosis. It is important to instruct patients to drink sufficient fluids and to continue insulin injections when they become sick.