Currently, the use of SGLT2 inhibitors is becoming more widespread, both for their role in controlling diabetes, and for their pleiotropic effects on glomerular hyperfiltration and heart failure. Along with their positive effects, these drugs can lead to various complications, the most severe being euglycemic ketoacidosis. The clinical case we have reported precisely describes this potentially serious complication which occurred in a 47-year-old patient who had been on SGLT2 inhibitor therapy for 5 years. In the resolution of this case we used, in addition to standard therapy, the continuous infusion of somatostatin, resulting in a rapid resolution of ketoacidosis and an improvement in the clinical condition.
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Cleve Clin J Med
January 2025
Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, OH; Clinical Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH.
Diabetic ketoacidosis (DKA) was historically considered a condition typical of type 1 diabetes. However, patients with type 2 diabetes may present with DKA, usually with higher blood glucose levels and milder ketoacidosis. With the increased use of sodium-glucose cotransporter 2 (SGLT-2) inhibitors, the variant euglycemic DKA has been described.
View Article and Find Full Text PDFAnn Med
December 2025
Intensive Care Unit, State Institute for Infectious Diseases São Sebastião, Rio de Janeiro, Rio de Janeiro, Brazil.
Background/objectives: Pregnant and postpartum women have a higher risk for developing severe Covid-19 and other clinical and obstetric complications. This study aims to evaluate the frequency of metabolic acidosis with elevated anion gap and describe a case series of euglycemic ketoacidosis (EKA) in pregnant and postpartum women with severe confirmed or suspected Covid-19.
Materials And Methods: Observational retrospective study carried in a reference intensive care unit from May 2020 to June 2022.
Cureus
November 2024
Internal Medicine, Wright State University, Dayton, USA.
Acidemia arises primarily from the accumulation of carbon dioxide or the loss of bicarbonate, leading to a pH decrease within the body, which can be fatal if severe and not promptly addressed. Metabolic acidemia occurs due to a loss of bicarbonate and can manifest through direct losses of bicarbonate via renal or gastrointestinal routes, or through the accumulation of anions such as lactic acid or ketoacids, leading to an anion gap metabolic acidosis. Many common etiologies for lactic acid and ketoacid generation exist, including medication-induced causes.
View Article and Find Full Text PDFOxf Med Case Reports
December 2024
Department of Endocrinology, Nil Ratan Sircar Medical College and Hospital, 138, Acharya Jagdish Chandra Bose Road, Sealdah, Raja Bazar, Kolkata, West Bengal 700014, India.
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