Acute Pancreatitis-Induced Euglycemic Diabetic Ketoacidosis

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a class of medications utilized for the treatment of diabetes mellitus by mechanisms promoting incretin release and insulin production. Although poorly understood, cases of acute pancreatitis have been observed in patients taking GLP-1 RAs. Sodium-glucose co-transporter-2 inhibitors (SGLT-2is) are another class of diabetic medications inhibiting renal glucose reabsorption which have been associated with rare cases of euglycemic ketoacidosis. Acute pancreatitis itself has been an observable cause of diabetic ketoacidosis, although typically in a hyperglycemia state. In this case report, we present a patient on SGLT-2is and GLP-1 RAs who developed acute pancreatitis, which may have precipitated euglycemic diabetic ketoacidosis (eu-DKA).