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Euglycemic Ketoacidosis.

Benedetta Maria Bonora1, Angelo Avogaro1, Gian Paolo Fadini2

  • 1Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padova, Italy.

Current Diabetes Reports
|May 20, 2020
PubMed
Summary
This summary is machine-generated.

Euglycemic ketoacidosis (euKA), a dangerous diabetic complication, can occur with normal or low blood sugar. This review covers its causes, symptoms, and management, especially with SGLT2 inhibitor use.

Keywords:
AlcoholEuglycemic ketoacidosisKetoacidosisPregnancySodium-glucose cotransporter-2 inhibitorsStarvation

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Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Pharmacology

Background:

  • Diabetic ketoacidosis (DKA) is a severe diabetes complication.
  • Euglycemic DKA (euKA) presents with normal or mild hyperglycemia, complicating diagnosis.
  • Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are increasingly associated with euKA.

Purpose of the Study:

  • To review the pathophysiology, etiologies, clinical presentation, and management of euKA.
  • To highlight diagnostic challenges posed by euKA, particularly in non-diabetic individuals.
  • To discuss the role of SGLT2 inhibitors in the recent resurgence of interest in euKA.

Main Methods:

  • Literature review of recent studies on euKA.
  • Analysis of clinical cases and epidemiological data.
  • Synthesis of current understanding of euKA pathophysiology and treatment.

Main Results:

  • euKA can occur in diabetic and non-diabetic individuals.
  • Conditions predisposing to euKA include SGLT2i use, pregnancy, caloric restriction, glycogen storage diseases, defective gluconeogenesis, and substance abuse.
  • Delayed diagnosis of euKA due to misleading glucose levels can lead to adverse outcomes.

Conclusions:

  • euKA is a critical condition requiring prompt recognition and management.
  • Physicians must consider euKA in patients with suggestive symptoms, even with normal glycemia.
  • Further research is needed to optimize the diagnosis and treatment strategies for euKA.