Euglycemic Diabetic Ketoacidosis Secondary to Dapagliflozin Use: a Case Report

Publication date: Available online 20 November 2017
Source:The Journal of Emergency Medicine
Author(s): Felicity Brown, Tamara McColl
BackgroundSodium-glucose co-transporter-2 (SGLT2) inhibitors are a novel class of oral antihyperglycemic agents. They are associated with rare cases of euglycemic diabetic ketoacidosis (DKA), which presents a diagnostic challenge in the emergency department (ED) and potentially severe consequences if missed.Case ReportA 53-year-old man with type 2 diabetes mellitus and a recent Roux-en-Y gastric bypass surgery presented to the ED with nausea, vomiting, and generalized abdominal pain. His medications included dapagliflozin. Work-up revealed anion-gap acidosis, which prompted us to send serum ketone levels despite a blood glucose level of 9.8 mmol/L (162 mg/dL). The patient was ultimately diagnosed with euglycemic DKA.Why Should an Emergency Physician Be Aware of This?Patients on SGLT2 inhibitors may present in DKA despite having normal blood glucose levels. It is important for emergency physicians to be aware of this phenomenon in all SGLT2-inhibitor users, as a delay in the diagnosis of DKA can be life threatening.



from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2BiE2PI