Euglycemic diabetic ketoacidosis of unknown Etiology in a type 2 diabetic patient

Euglycemic diabetic ketoacidosis is a rare form of DKA characterized by severe ketosis and metabolic acidosis without marked hyperglycemia. We report a 45-year-old female with insulin-dependent diabetes and chronic kidney disease, initially presenting with acute heart failure, who later developed euglycemic DKA. Despite near-normal glucose levels, high anion gap metabolic acidosis with significant ketones highlighted this crisis. Treatment included fluids, insulin with dextrose, and intensive monitoring. This case underscores the need for early recognition of euglycemic DKA, especially in complex patients, to improve outcomes.