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Year : 2019  |  Volume : 11  |  Issue : 1  |  Page : 35-37

Sodium-glucose co-transporter 2 inhibitor-induced euglycemic diabetic ketoacidosis in a Type 2 diabetes patient not absolutely insulin-deficient!

1 Department of Diabetes and Endocrinology, Rashid Center for Diabetes and Research, Ajman, United Arab Emirates
2 Department of Internal Medicine, Sheikh Khalifa General Hospital, Ajman, United Arab Emirates

Correspondence Address:
Dr. Mamoun Mukthar
Rashid Centre for Diabetes and Research, University Street, P. O. Box: 21499, Ajman
United Arab Emirates
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijmbs.ijmbs_92_18

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Sodium-glucose co-transporter 2 (SGLT2) inhibitors are the newest class of oral antidiabetic agents. In addition to glucose lowering, they have other advantageous effects on blood pressure and body weight. The use of those agents has increased exponentially after the emerging evidence of cardiovascular protection following the publication of the EMPA-REG OUTCOME study. Although they are relatively safe and effective, they are not without side effects. Perhaps, the most serious complication is euglycemic diabetic ketoacidosis (DKA). Several cases were reported in the literature. We describe a case of severe DKA in association with the use of an SGLT2 inhibitor (empagliflozin) in a 69-year-old male with type 2 diabetes who is not absolutely insulin deficient following knee replacement. The case highlights the increased risk of DKA and the importance of discontinuation of SGLT2 inhibitors before major surgery.

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