A Case of Euglycemic Diabetic Ketoacidosis due to Empagliflozin Use in a Patient with Type 1 Diabetes Mellitus

J Coll Physicians Surg Pak. 2022 Jul;32(7):928-930. doi: 10.29271/jcpsp.2022.07.928.

Abstract

Euglycemic diabetic ketoacidosis is characterised by serum blood glucose <250 mg/dl, arterial blood pH <7.35, and the presence of ketones in urine or blood. Here, we present a 36-year female with type-1 diabetes mellitus, a case of euglycemic diabetic ketoacidosis, who was admitted to the emergency unit with nausea, vomiting, and confusion after using empagliflozin, which was added to her treatment one month ago. She was followed up in the intensive care unit for four days. Empagliflozin was discontinued. Intravenous fluids and insulin infusions were given. The patient, whose metabolic acidosis regressed, was discharged with the necessary recommendations and training. Euglycemic diabetic ketoacidosis should be kept in mind as a differential diagnosis in patients with type-1 diabetes and type-2 diabetes presenting with acidosis. Attention should be paid to the patients' medications and whether there are SGLT-2 inhibitors among these drugs. Key Words: Diabetes mellitus, Sodium-glucose co-transporter-2 inhibitors, Euglycemic diabetic ketoacidosis, Empagliflozin.

Publication types

  • Case Reports

MeSH terms

  • Benzhydryl Compounds / adverse effects
  • Diabetes Mellitus, Type 1* / drug therapy
  • Diabetic Ketoacidosis* / chemically induced
  • Diabetic Ketoacidosis* / diagnosis
  • Female
  • Glucosides / adverse effects
  • Humans
  • Sodium-Glucose Transporter 2 Inhibitors* / adverse effects

Substances

  • Benzhydryl Compounds
  • Glucosides
  • Sodium-Glucose Transporter 2 Inhibitors
  • empagliflozin