Euglycemic diabetic ketoacidosis following major vascular surgery is a new item on the differential for postoperative acidosis

Clara M Gomez-Sanchez; Bian X Wu; Jeffrey E Gotts; Robert W Chang

doi:10.1016/j.jvscit.2021.10.006

Euglycemic diabetic ketoacidosis following major vascular surgery is a new item on the differential for postoperative acidosis

J Vasc Surg Cases Innov Tech. 2021 Oct 22;7(4):778-780. doi: 10.1016/j.jvscit.2021.10.006. eCollection 2021 Dec.

Authors

Clara M Gomez-Sanchez¹, Bian X Wu², Jeffrey E Gotts³, Robert W Chang²

Affiliations

¹ Division of Vascular and Endovascular Surgery, Department of Surgery, University of California San Francisco, San Francisco, Calif.
² Department of Vascular Surgery, Kaiser Permanente Northern California, Oakland, Calif.
³ Department of Critical Care Medicine, Kaiser Permanente Northern California, Oakland, Calif.

Abstract

New pharmacologic advances in the treatment of diabetes include SGLT-2 inhibitors, which have been demonstrated in randomized-controlled clinical trials to reduce overall and cardiac-specific mortality and slow progression of chronic kidney disease. Euglycemic diabetic ketoacidosis is a rare but life-threatening complication associated with the use of SGLT-2 inhibitors. Here we describe a case of severe euglycemic diabetic ketoacidosis after lower extremity bypass in a patient taking an SGLT-2 inhibitor. Awareness of this potential complication is essential as these novel agents are increasingly used in patients with cardiovascular disease.

Keywords: Diabetic acidosis; Peripheral artery disease; Postoperative complication; SGLT-2 inhibitors.

Publication types

Case Reports