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Clin Pract Cases Emerg Med · Aug 2020
Euglycemic Diabetic Ketoacidosis Precipitated by SGLT-2 Inhibitor Use, Pericarditis, and Fasting: A Case Report.
- Rebecca A Mendelsohn, Anabelle N Taveras, Benjamin A Mazer, and Lisa M Clayton.
- Florida Atlantic University Charles E. Schmidt College of Medicine, Department of Emergency Medicine, Boca Raton, Florida.
- Clin Pract Cases Emerg Med. 2020 Aug 1; 4 (3): 389-392.
IntroductionDiabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. Less prevalent is euglycemic DKA (eDKA)-DKA with serum glucose less than 200 mg/dL; however, it is increasing in frequency with the introduction of sodium glucose cotransporter 2 (SGLT-2) inhibitors for treatment of type 2 diabetes.Case ReportWe report a case of SGLT-2 inhibitor-associated eDKA presenting with concurrent acute pericarditis.DiscussionOur case suggests that the cause of eDKA can be multifactorial when decreased oral intake occurs in the setting of an acute cause of physiologic stress.ConclusionPrompt recognition of eDKA in the emergency department may allow earlier diagnosis and treatment directed at one or more of its underlying causes.
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