Euglycemic diabetic ketoacidosis: another masquerader!

Authors

  • Bhargavi Kumar Department of Medicine, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
  • Saravanan Thangavelu Department of Medicine, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
  • Rajgokul Prabhakar Department of Medicine, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20194283

Keywords:

Empagliflozin, SGLT2 inhibitor, Type 2 diabetes, Euglycemic ketoacidosis

Abstract

Euglycemic ketoacidosis is defined by the triad of euglycemia, metabolic acidosis and ketonemia or ketonuria. In the current era of diabetic management, it is a serious concern with the usage of sodium glucose co-transporter 2 (SGLT2) inhibitors potentiated by a number of precipitating agents. Empagliflozin though a novel oral hypoglycemic agent in this category may also lead to this potential complication. Here we report a 59 year old male, type 2 diabetic who was on empagliflozin and presented with euglycemic ketoacidosis after a binge of alcohol.

 

References

Rosenwasser RF, Sultan S, Sutton D, Choksi R, Epstein BJ. SGLT 2 inhibitors and their potential in treatment of Diabetes, Diabet Metabol Syndrome Obes. 2013;6:453-67.

U.S. Food and Drug Administration. Drug Safety Communication: FDA warns that SGLT2 inhibitors for diabetes may result in a serious condition of too much acid in the blood, 2015. Available at: http://www.fda.gov/downloads/Drugs/Drugsafety/UCM446954. Accessed on 05 October 2018.

Munro JF, Campbell IW, McCuish AC, Duncan LJ. Euglycaemic diabetic ketoacidosis. Br Med J. 1973;2:578-80.

Miles JM, Gerich JE. Glucose and ketone body kinetics in diabetic ketoacidosis. Clin Endocrinol Metab. 1983;12:303-19.

Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes (EMPA-REG OUTCOME). New Engl J Med. 2015;373:2117-28.

Rosenstock J, Ferrannini E. Euglycemic diabetic ketoacidosis: a predictable, detectable, and preventable safety concern with SGLT2 inhibitors. Diab Care. 2015;38(9):1638-42.

Gammons T, Counselman FL. Sodium-glucose cotransporter-2 induced diabetic ketoacidosis with minimal hyperglycemia. Clin Practice Cases Emerg Med. 2018;2(1):47-50.

Candelario N, Wykretowicz J. The DKA that wasn't: a case of euglycemic diabetic ketoacidosis due to empagliflozin. Oxford Med Case Report. 2016;2016(7):144-6.

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Published

2019-09-25

How to Cite

Kumar, B., Thangavelu, S., & Prabhakar, R. (2019). Euglycemic diabetic ketoacidosis: another masquerader!. International Journal of Basic & Clinical Pharmacology, 8(10), 2338–2340. https://doi.org/10.18203/2319-2003.ijbcp20194283

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Section

Case Reports