Research Article | Open Access
Volume 2022 - 1 | Article ID 221 | https://dx.doi.org/10.51521/IJDCR.2022.1101
Academic Editor: John Bose
GOWRY REDDY MD1, AMISHA TAILOR MD2, ANCA TANASE MD3, JEFFREY KANTOR MD4
1Department of Internal Medicine, Saint
Clare’s Denville Hospital 25 Pocono Road, Denville, NJ, 07834; Email:
greddy3@primehealthcare.com; Phone No: 973- 625-6000; ORCID No.
0000-0003-0774-5809
2Department of Internal Medicine, Saint
Clare’s Denville Hospital 25 Pocono Road, Denville, NJ, 07834, Email:
atailor2@primehealthcare.com; Phone No: 973-625-6000; ORCID No.
0000-0002-4261-8648
3Anca Tanase, Department of Internal Medicine, Saint Clare’s Denville Hospital 25 Pocono Road, Denville, NJ, 07834; Email: anca88t@yahoo.com; Phone No: 973-625-6000; ORCID No. 0000-0002-3338-574X
4Department of Internal Medicine, Saint Clare’s Denville Hospital, 25 Pocono Road, Denville, NJ, USA ORCID No. 0009-0000-6654-7023
Corresponding author: Gowry Reddy, Department of Internal Medicine, Saint Clare’s Denville Hospital 25 Pocono Road, Denville, NJ, 07834; Email: greddy3@primehealthcare.com; Phone No: 973- 625-6000; ORCID No. 0000-0003-0774-5809
Citation: Gowry R, Amisha T, Anca T , Jeffrey K (2022)
A Case of SGLT-2i Induced Euglycemic Diabetic Ketoacidosis in Setting of
Gastrointestinal Stress. Int J Diabetes Case Rep, 1(1);1-3.
Copyrights: © 2022, Gowry R, et al.,
This is an open-access article distributed under the terms of the Creative Commons
Attribution 4.0 International License, which permits unrestricted use,
distribution and reproduction in any medium, provided the original author and
source are credited.
ABSTRACT
Euglycemic DKA (euDKA) is a rare, uncommon variant
of DKA, characterized by the imbalance between insulin and counterregulatory
hormones. Lately, the use of SGLT2 inhibitors is known to incite euDKA, which
is often missed on initial presentation. In this case, we present a scenario of
a 61-year-old African American male with a history of hypertension, CAD s/p
CABG, and type 2 diabetes mellitus on SGLT2i (empagliflozin) with a clinical
picture of normoglycemic DKA process. With a pH of 7.14, bicarbonate of 8
mEq/L, anion gap (AG) of 17mEq/L, ketoacidosis, and glucosuria, the patient met
criteria for euDKA; however, the initial clinical diagnosis of euDKA was
overlooked by the possibility of an underlying infectious gastroenteritis,
given his recent history of travel with passengers with similar presentation,
causing a delay in euDKA management. The management of euDKA is like that of a
typical DKA, inculcating aggressive fluid resuscitation and insulin, followed
by a permanent discontinuation of SGLT2i. Thus, this case highlights the
importance of understanding SGLT2i induced euDKA and its early diagnostic and
timely management to prevent further complications.
KEYWORDS: Empagliflozin, SGLT2i, Euglycemic DKA, Insulin, Stress
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