A Rare Case of Empagliflozin-Induced Euglycemic Diabetic Ketoacidosis Obscured by Alkalosis

Daniel A Fernandez Felix; Gloriana Madrigal Loria; Sapna Sharma; Shorabh Sharma; Carlos E Arias Morales

doi:10.7759/cureus.25818

A Rare Case of Empagliflozin-Induced Euglycemic Diabetic Ketoacidosis Obscured by Alkalosis

Cureus. 2022 Jun 10;14(6):e25818. doi: 10.7759/cureus.25818. eCollection 2022 Jun.

Authors

Daniel A Fernandez Felix^{1

2}, Gloriana Madrigal Loria^{1

2}, Sapna Sharma^{1

2}, Shorabh Sharma^{1

2}, Carlos E Arias Morales^{1

2}

Affiliations

¹ Medicine, St. Barnabas Hospital (SBH) Health System, Bronx, USA.
² Clinical Medicine, Sophie Davis School of Medicine, City University of New York, Bronx, USA.

Abstract

Empagliflozin-induced euglycemic diabetic ketoacidosis is a life-threatening metabolic complication of diabetes mellitus characterized by metabolic acidosis, ketonemia, and relatively normal serum glucose levels. We present a rare case of empagliflozin-induced diabetic ketoacidosis obscured by alkalosis. This case report aims to create awareness among clinicians about this entity and consider this diagnosis in their differential, especially in patients taking sodium-glucose co-transporter (SGLT-2) inhibitors who present to the hospital with unspecific symptoms that may not suggest DKA.

Keywords: alkalosis; diabetic keto-alkalosis; diabetic ketoacidosis (dka); euglycemic diabetic ketoacidosis; sodium glucose co-transporter 2 inhibitors (sglt2i).

Publication types

Case Reports