Euglycemic diabetic ketoacidosis (euDKA) is a rare but life-threatening adverse effect of sodium-glucose cotransporter 2 (SGLT2) inhibitors. We present a case of delayed euDKA seven days after cure of acute pancreatitis and discharge from the hospital of a 51-year-old man with type 2 diabetes mellitus (T2DM) managed with a combination of antidiabetic medications, including the SGLT2 inhibitor dapagliflozin. Prior acute pancreatitis was postulated to be a contributing factor to the development of SGLT2 inhibitor-associated euDKA in this patient discharged from the hospital. The patient was managed accordingly and improved clinically while his oral hypoglycemic agents were stopped. The risk of euDKA from SGLT2 inhibitor therapy may be increased by some stress factors (eg, infection, surgery, acute illness, low-carbohydrate diet, excessive alcohol intake). As these SGLT2 inhibitors become a popular therapeutic strategy for the management of hyperglycemia in T2DM, clinicians should be aware that acute illnesses such as pancreatitis in patients with T2DM can be potential predisposing factors for the development of SGLT2 inhibitor-associated euDKA.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.clinthera.2023.05.006 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Euglycemic diabetic ketoacidosis associated metabolic encephalopathy caused by dapagliflozin: a rare case report.
BMC Neurol
January 2025
Department of Neurology, Haiyan People's Hospital, Jiaxing City, 314300, Zhejiang Province, China.
Background: Sodium-glucose cotransporter-2(SGLT-2) inhibitors are a newer class of antidiabetic drugs with the increased risk of euglycemic diabetic ketoacidosis(EuDKA). Encephalopathy is a rare but life-threatening event of EuDKA. Due to paradoxically normal or slightly elevated serum glucose levels, it's easy to be mimicked by cerebral infarction, structural brain damage, thus leading to delayed diagnosis and causing seriously irreversible brain injury.
View Article and Find Full Text PDFLife-threatening dapagliflozin-associated euglycaemic diabetic ketoacidosis in a postoperative patient.
BMJ Case Rep
January 2025
Kasturba Medical College Mangalore, Mangalore, Karnataka, India
Euglyceamic diabetic ketoacidosis (EuDKA) is an uncommon but serious diabetes mellitus complication associated with risk factors such as fasting, surgery, pregnancy and, more recently, the use of sodium-glucose cotransporter-2 inhibitors (SGLT2i). This case is of a woman with type 2 diabetes and hypertension in her 50s who underwent an incarcerated umbilical hernia repair and abdominoplasty. Two days after discharge, she was readmitted with nausea, vomiting, loss of appetite, low-grade fever and breathing difficulty.
View Article and Find Full Text PDFKetoacidosis and SGLT2 Inhibitors: A Narrative Review.
Metabolites
May 2024
Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy.
An acute metabolic complication of diabetes mellitus, especially type 1, is diabetic ketoacidosis (DKA), which is due to an increase in blood ketone concentrations. Sodium/glucose co-transporter-2 inhibitor (SGLT2-i) drugs have been associated with the occurrence of a particular type of DKA defined as euglycemic (euDKA), characterized by glycemic levels below 300 mg/dL. A fair number of euDKA cases in SGLT2-i-treated patients have been described, especially in the last few years when there has been a significant increased use of these drugs.
View Article and Find Full Text PDF"Normal but Catastrophic" Euglycemic Diabetic Ketoacidosis Precipitated by Sodium-Glucose Cotransporter-2 Inhibitor Use: A Case Report.
Cureus
November 2023
Interventional Cardiology, Adventist Medical Center Manila, Pasay City, PHL.
Euglycemic diabetic ketoacidosis (EuDKA) is an uncommon diabetic complication. Just like diabetic ketoacidosis (DKA), EuDKA is a medical emergency. EuDKA is primarily related to the imbalance between insulin and counter-regulatory hormones, with an elevated insulin/glucagon ratio, and is characterized by blood glucose near normal (blood glucose less than 250 mg/dL) in the background of DKA.
View Article and Find Full Text PDFUnsuspected diabetic ketoacidosis after myocardial infarction in a patient treated with SGLT2 inhibitor increased length of stay in the hospital: how can it be prevented? A case report.
Eur Heart J Case Rep
August 2023
Department of Cardiology, Mouscron Hospital Centre, Avenue de Fécamp 49, 7700 Mouscron, Belgium.
Background: As the use of sodium-glucose co-transporter 2 inhibitors (SGLT2is) has expanded beyond glucose-lowering therapy in type 2 diabetes mellitus (T2DM), including chronic kidney disease and heart failure, there has also been an increase in reported cases of diabetic ketoacidosis (DKA) associated with SGLT2i.
Case Summary: A 77-year-old woman with T2DM presented to the emergency department with ST-segment elevation myocardial infarction (MI) complicated by atrial fibrillation. Her medications included empagliflozin, an SGLT2i, initiated for T2DM.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!