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Updated: Feb 23, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
[Severe atypical ketoacidosis due to SGLT2-inhibitor therapy : Two case reports]
T G K Breuer1, K Kampmann1, A Wutzler2
1Diabetes-Zentrum Bochum/Hattingen, Katholisches Klinikum Bochum, Klinikum der Ruhr-Universität Bochum, Gudrunstr. 56, 44791, Bochum, Deutschland.
Abstract:
Two female patients were admitted due to ketoacidosis. Serum glucose was moderately elevated. The patients exhibited abdominal and neurologic symptoms. Treatment consisted of metformin, insulin glargin and empagliflozin, as well as glimepiride, insulin detemir and empagliflozin, respectively. Treatment with intravenous fluid replacement, insulin, glucose, potassium and buffer solution led to a normalisation of pH and serum glucose levels. Our report describes two cases of atypical ketoacidosis with moderately elevated serum glucose during sodium-glucose co-transporter-2 (SGLT2) inhibitor therapy.
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