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Euglycemic Diabetic Ketoacidosis Precipitated by SGLT-2 Inhibitor Use, Pericarditis, and Fasting: A Case Report
Rebecca A Mendelsohn1, Anabelle N Taveras1, Benjamin A Mazer1
1Florida Atlantic University Charles E. Schmidt College of Medicine, Department of Emergency Medicine, Boca Raton, Florida.
Introduction:
Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. Less prevalent is euglycemic DKA (eDKA)-DKA with serum glucose less than 200 mg/dL; however, it is increasing in frequency with the introduction of sodium glucose cotransporter 2 (SGLT-2) inhibitors for treatment of type 2 diabetes.
Case Report:
We report a case of SGLT-2 inhibitor-associated eDKA presenting with concurrent acute pericarditis.
Discussion:
Our case suggests that the cause of eDKA can be multifactorial when decreased oral intake occurs in the setting of an acute cause of physiologic stress.
Conclusion:
Prompt recognition of eDKA in the emergency department may allow earlier diagnosis and treatment directed at one or more of its underlying causes.
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