Related Experiment Video
Updated: Dec 29, 2025

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
A potential diagnostic problem on the ICU: Euglycaemic diabetic Ketoacidosis associated with SGLT2 inhibition
Idrisu Sanusi1, Alexander Sarnowski1, David Russell-Jones2
1Intensive Care Unit, Royal Surrey County Hospital NHS Foundation Trust, Egerton Road, Guildford, Surrey GU2 7XX, UK.
Abstract:
Sodium glucose cotransporter 2 (SGLT2) inhibitors are the latest class of oral hypoglycaemic agents approved to treat type II diabetes. Their use is increasing and as such more patients will present to critical care whilst on this treatment. However, there have been several case reports of euglycaemic diabetic ketoacidosis associated with the use of these agents. Under such circumstances the blood glucose is often normal or only moderately elevated and hence the diagnosis may be delayed resulting in inappropriate therapy. In this review we describe a case of SGLT2 mediated ketoacidosis who presented to our intensive care unit, discuss the proposed pathophysiology behind this development of ketoacidosis as well as its potential prevention, management and treatment.
Related Concept Videos
Glucose Transporters
Facilitated diffusion-glucose transporters (GLUTs) are encoded by the solute-linked carrier (SLC) family 2, subfamily A gene family, or SLC2A. The 14 GLUT protein members are distributed into three classes:
Diabetes: Symptoms, Diagnosis, and Complications
Dipeptidyl Peptidase 4 Inhibitors
Diabetes Mellitus: Type 2 and Gestational
Hypoglycemia and Glucagon
Oral Hypoglycemic Agents: Glinides

