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Euglycemic Diabetic Ketoacidosis Secondary to Dapagliflozin in a Patient with Colon Malignancy

Eleni Papadokostaki1, Evangelos Liberopoulos2

  • 1Emergency Department, General Hospital of Heraklion "Venizeleio-Pananeio," Heraklion, 71409, Greece.

Case Reports in Endocrinology
|June 15, 2019
PubMed

Insights

Sodium-glucose cotransporter 2 (SGLT2) inhibitors offer benefits for type 2 diabetes but can cause euglycemic diabetic ketoacidosis (euDKA). This case highlights euDKA from dapagliflozin in a patient with colon cancer.

Area of Science:

  • Endocrinology
  • Pharmacology
  • Oncology

Background:

  • Sodium-glucose cotransporter 2 (SGLT2) inhibitors are increasingly prescribed for type 2 diabetes management.
  • These agents provide benefits like weight loss, blood pressure reduction, and cardioprotective effects.
  • Awareness of adverse effects, including euglycemic diabetic ketoacidosis (euDKA), is crucial for safe clinical practice.

Observation:

  • A case of euDKA was observed in a patient with type 2 diabetes and colon cancer.
  • The patient developed euDKA secondary to the use of dapagliflozin, an SGLT2 inhibitor.
  • This presentation occurred despite maintaining relatively normal blood glucose levels.

Findings:

  • This report details the first instance of SGLT2 inhibitor-associated euDKA in a patient with underlying colon cancer.
  • The findings underscore the potential for euDKA as a serious adverse event associated with SGLT2 inhibitors.
  • The interaction between SGLT2 inhibitors, diabetes, and malignancy warrants further investigation.

Implications:

  • Physicians must maintain a high index of suspicion for euDKA in patients treated with SGLT2 inhibitors, especially those with comorbidities like cancer.
  • Early recognition and management of euDKA are essential to prevent severe complications.
  • This case emphasizes the need for comprehensive patient monitoring and risk assessment when prescribing SGLT2 inhibitors.

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