• Am J Emerg Med · Sep 2023

    Case Reports

    Euglycemic diabetic ketoacidosis associated with ST segment elevation myocardial infarction following SGLT-2 inhibitor therapy.

    • Nart Zafer Baytuğan, ÇelikAziz İnanAİDepartment of Cardiology, Gebze Fatih State Hospital, Kocaeli, Turkey., Tahir Bezgin, and Metin Çağdaş.
    • Department of Cardiology, Gebze Fatih State Hospital, Kocaeli, Turkey. Electronic address: nartzafer@hotmail.com.
    • Am J Emerg Med. 2023 Sep 1; 71: 250.e1250.e3250.e1-250.e3.

    AbstractSodium-glucose cotransporter-2 (SGLT-2) inhibitors are the latest approved class of oral antidiabetic agents that inhibit renal SGLT-2 receptors and increase urinary glucose excretion in the luminal membrane of the proximal tubule. Diabetic ketoacidosis (DKA) is a triad of hyperglycemia, ketosis, and a high anion gap with metabolic acidosis. We present the case of 61 years-old men with severe euglycemic DKA (EDKA) complicated ST-segment elevation myocardial infarction following SGLT-2 inhibitor therapy for type 2 diabetes mellitus. Atypical presentation of ketoacidosis without hyperglycemia can delay diagnosis and may result in catastrophic complications. Quick diagnosis, appropriate clinical and biochemical assessment, and effective treatment protocols ensure successful resolution of EDKA.Copyright © 2023 Elsevier Inc. All rights reserved.

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