Why the study?
Euglycemic diabetic ketoacidosis is a rare but life-threatening complication in diabetic patients treated with SGLT2 inhibitors.
Euglycemic diabetic ketoacidosis should be considered in diabetic patients treated with SGLT2 inhibitors who develop metabolic acidosis during critical illness such as acute pulmonary embolism.
May warrant ketone checks despite euglycemia in SGLT2i users with PE; leaves open whether PE specifically precipitates Eu-DKA.
Euglycemic diabetic ketoacidosis (Eu-DKA) is a rare but life-threatening complication in diabetic patient treated with sodium-glucose cotransporter 2 inhibitors (SGLT2i). A 71-year-old diabetic female treated with empagliflozin presented to the ED with shortness of breath. Diagnosis of acute pulmonary embolism was confirmed initially. She was treated conservatively with subcutaneous enoxaparin 60 mg bidaily. and oxygen therapy. Respiratory distress associated with anion gap — metabolic acidosis and ketosis developed on the following days however her blood glucose levels were always within normal limit. Clinical recovery was gained after stopping the drug, administering rehydration, and insulin drip. Complica-tion of DKA without hyperglycaemia should be consid-ered while evaluating ketoacidosis in diabetic patients treated with SGLT2i, particularly in critical illness cases.
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Wibawa et al. (2021) studied this question.
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