Beyond glucose, complications from the use of new antidiabetic drugs: a case report
DOI:
https://doi.org/10.16921/pfr.v11i1.399Keywords:
Euglycemic diabetic ketoacidosis, SGLT2 inhibitors, dapagliflozin, metabolic acidosis, type 2 diabetes mellitusAbstract
Euglycemic diabetic ketoacidosis (EDA) is an emerging condition associated with the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors, characterized by metabolic acidosis with an elevated anion gap, ketosis, and normal or slightly elevated glucose levels.
We present the case of an 88-year-old female patient with multiple comorbidities, including type 2 diabetes mellitus treated with dapagliflozin, who was admitted with progressive dyspnea in the context of a respiratory infection.
The tests revealed metabolic acidosis with an elevated anion gap and a blood glucose level of 119 mg/dL, leading to a diagnosis of euglycemic diabetic ketoacidosis.
Downloads
References
American Diabetes Association. (2026). Standards of care in diabetes—2026. Diabetes Care, 49(Suppl. 1).
Bonora, B. M., Avogaro, A., & Fadini, G. P. (2020). Euglycemic ketoacidosis. Current Diabetes Reports, 20(7), 25.
Long, B., Lentz, S., Koyfman, A., & Gottlieb, M. (2021). Euglycemic diabetic ketoacidosis: Etiologies, evaluation, and management. American Journal of Emergency Medicine, 44, 157–160.
Mahler, S. A., et al. (2018). The HEART pathway randomized trial. Circulation, 11(6), e004882.
Nasa, P., Chaudhary, S., & Shrivastava, P. (2021). Euglycemic diabetic ketoacidosis: A missed diagnosis. World Journal of Diabetes, 12(5), 514–523.
Patel, H., & Jepsen, J. (2024). Gallstone disease: Clinical manifestations and management. American Family Physician, 110(3), 215–224.
Peters, A. L., et al. (2024). Euglycemic diabetic ketoacidosis and SGLT2 inhibitors: Updated clinical guidance. The Lancet Diabetes & Endocrinology, 12(2), 85–96.
