Euglycemic Diabetic Ketoacidosis in a Patient With Type 2 Diabetes After Treatment With Empagliflozin

Sodium–glucose cotransporter 2 (SGLT2) inhibitors have been associated with euglycemic diabetic ketoacidosis (eDKA). All reports to date have involved canagliflozin (Invokana; Janssen Pharmaceuticals), with the exception of one case associated with ipragliflozin (1). It has been anticipated that eDKA is a class effect, but no case reports of eDKA with other SGLT2s have been reported. Here, we report a case of eDKA in a patient with type 2 diabetes treated with empagliflozin. A 64-year-old woman with a 15-year history of type 2 diabetes and a 5-day history of treatment with empagliflozin (Jardiance; Boehringer Ingelheim) presented to the emergency room (ER) for evaluation of shortness of breath. She had been treated with insulin for 10 years. At the time she started empagliflozin, she was taking liraglutide 1.8 mg per day. She had …