scholarly journals A Case of Severe Metabolic Acidosis due to Jardiance-Induced Euglycemic Diabetic Ketoacidosis

Cureus ◽  
2021 ◽  
Author(s):  
Nataliia Dyatlova ◽  
Yetunde B Omotosho ◽  
Robin Sherchan ◽  
Jishna Shrestha ◽  
Venkata Buddharaju
Keyword(s):  
Metabolic Acidosis ◽  
Diabetic Ketoacidosis ◽  
Severe Metabolic Acidosis ◽  
Euglycemic Diabetic Ketoacidosis

scholarly journals Euglycemic diabetic ketoacidosis: a diagnostic and therapeutic dilemma

2017 ◽  
Vol 2017 ◽  
Author(s):  
Prashanth Rawla ◽  
Anantha R Vellipuram ◽  
Sathyajit S Bandaru ◽  
Jeffrey Pradeep Raj
Keyword(s):  
Metabolic Acidosis ◽  
Blood Glucose ◽  
Diabetic Ketoacidosis ◽  
Clinical Suspicion ◽  
Anion Gap ◽  
Normal Blood ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
High Clinical Suspicion ◽  
Euglycemic Diabetic Ketoacidosis

Summary Euglycemic diabetic ketoacidosis (EDKA) is a clinical triad comprising increased anion gap metabolic acidosis, ketonemia or ketonuria and normal blood glucose levels <200 mg/dL. This condition is a diagnostic challenge as euglycemia masquerades the underlying diabetic ketoacidosis. Thus, a high clinical suspicion is warranted, and other diagnosis ruled out. Here, we present two patients on regular insulin treatment who were admitted with a diagnosis of EDKA. The first patient had insulin pump failure and the second patient had urinary tract infection and nausea, thereby resulting in starvation. Both of them were aggressively treated with intravenous fluids and insulin drip as per the protocol for the blood glucose levels till the anion gap normalized, and the metabolic acidosis reversed. This case series summarizes, in brief, the etiology, pathophysiology and treatment of EDKA. Learning points: Euglycemic diabetic ketoacidosis is rare. Consider ketosis in patients with DKA even if their serum glucose levels are normal. High clinical suspicion is required to diagnose EDKA as normal blood sugar levels masquerade the underlying DKA and cause a diagnostic and therapeutic dilemma. Blood pH and blood or urine ketones should be checked in ill patients with diabetes regardless of blood glucose levels.

Prolonged euglycemic diabetic ketoacidosis triggered by a single dose of sodium–glucose cotransporter 2 inhibitor

2020 ◽  
Vol 13 (10) ◽  
pp. e235969
Author(s):  
Maki Miwa ◽  
Mikio Nakajima ◽  
Richard H Kaszynski ◽  
Hideaki Goto
Keyword(s):  
Single Dose ◽  
Metabolic Acidosis ◽  
Blood Glucose ◽  
Diabetic Ketoacidosis ◽  
Sglt2 Inhibitor ◽  
Glucose Levels ◽  
Intravenous Insulin ◽  
Blood Glucose Levels ◽  
Sodium Glucose Cotransporter ◽  
Euglycemic Diabetic Ketoacidosis

A 45-year-old woman was admitted for diabetic ketoacidosis (DKA). Aggressive rehydration and continuous intravenous insulin resulted in improved blood glucose levels; however, metabolic acidosis persisted. One day prior to admission, the patient took a single dose of a sodium–glucose cotransporter 2 (SGLT2) inhibitor and this likely contributed to the prolonged euglycemic DKA. A single dose of this drug remained effective for over 100 hours as evidenced by massive excretion of urine glucose continuing long after blood glucose normalisation. SGLT2 inhibitor use should be refrained in cases in which DKA has already occurred as they may result in increasing severity or prolonged DKA.

scholarly journals Euglycemic diabetic ketoacidosis: another masquerader!

2019 ◽  
Vol 8 (10) ◽  
pp. 2338
Author(s):  
Bhargavi Kumar ◽  
Saravanan Thangavelu ◽  
Rajgokul Prabhakar
Keyword(s):  
Metabolic Acidosis ◽  
Diabetic Ketoacidosis ◽  
Sglt2 Inhibitors ◽  
Oral Hypoglycemic Agent ◽  
Potential Complication ◽  
Hypoglycemic Agent ◽  
Male Type ◽  
Euglycemic Diabetic Ketoacidosis ◽  
Type 2 Diabetic

Euglycemic ketoacidosis is defined by the triad of euglycemia, metabolic acidosis and ketonemia or ketonuria. In the current era of diabetic management, it is a serious concern with the usage of sodium glucose co-transporter 2 (SGLT2) inhibitors potentiated by a number of precipitating agents. Empagliflozin though a novel oral hypoglycemic agent in this category may also lead to this potential complication. Here we report a 59 year old male, type 2 diabetic who was on empagliflozin and presented with euglycemic ketoacidosis after a binge of alcohol. 

scholarly journals Sodium–Glucose Cotransporter 2 Inhibitors and Euglycemic Diabetic Ketoacidosis: Metabolic Acidosis With a Twist

2016 ◽  
Vol 34 (4) ◽  
pp. 214-216 ◽  
Author(s):  
Aala Jaberi ◽  
Bhavna Seth ◽  
Devin Steenkamp ◽  
Sara Alexanian ◽  
Steven C. Borkan
Keyword(s):  
Metabolic Acidosis ◽  
Diabetic Ketoacidosis ◽  
Sodium Glucose Cotransporter ◽  
Euglycemic Diabetic Ketoacidosis
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