North Texas GME Research Forum 2023
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Download Poster or Presentation (207 KB)
Division
North Texas
Hospital
Medical City Arlington
Specialty
Internal Medicine
Document Type
Poster
Publication Date
4-28-2023
Keywords
diabetic ketoacidosis, DKA, diabetes mellitus, Euglycemic DKA, carbohydrate restricted diet
Disciplines
Endocrine System Diseases | Internal Medicine
Abstract
Euglycemic diabetic ketoacidosis (EuDKA) is a rare complication of type 2 diabetes mellitus (T2DM) characterized by normoglycemia in the presence of anion gap metabolic acidosis and blood ketone. EuDKA has been associated with the use of sodium-glucose cotransporter-2 inhibitors (SGLT2i) but the reported adverse events are scarce. We present a case of a 68-year-old gentleman with T2DM and coronary artery disease, who developed EuDKA after starting empagliflozin (Jardiance) with a low-carbohydrate diet for a few days. SGLT2i block proximal tubule glucose reabsorption, resulting in a state of carbohydrate starvation and subsequent ketosis. The combination of SGLT2i with a low-carbohydrate diet can enhance ketosis further, causing EuDKA. Because EuDKA is uncommon, delayed diagnosis and treatment can lead to other complications and prolonged hospitalization. SGLT2i has become popular for its antihyperglycemic, cardiovascular, and renal health benefits; however, physicians should be cautious to prescribe this medication when the patient is on a low-carbohydrate diet.
Original Publisher
HCA Healthcare Graduate Medical Education
Recommended Citation
Yeung, George; Duong, Nhi; Pole, Akshaj; Larsen, Benjamin; and Ahmed, Syed, "Euglycemic Diabetic Ketoacidosis Secondary to SGLT2 Inhibitors in Combination with a Low-Carbohydrate Diet" (2023). North Texas GME Research Forum 2023. 15.
https://scholarlycommons.hcahealthcare.com/northtexas2023/15