THU359 A Classical Case Of SGLT-2 Inhibitor Euglycemic Ketoacidosis In A Patient With Glucotoxicity
Abstract
Abstract Disclosure: S. Amankwah: None. O.B. Olajide: None. Background: SGLT-2 inhibitors have been demonstrated to be beneficial in protecting comorbid cardiovascular or kidney disease while providing modest improvement in glycemia. However, they are not ideal for initial therapy for patients with very poorly controlled type 2 diabetes. This is a case where SGLT-2 inhibitor monotherapy led to diabetic ketoacidosis. Clinical Case: A 68-year-old woman with type 2 diabetes for 30 years, hypertension, hyperlipidemia, and depression presented to the hospital with complaints of headache, nausea, vomiting, dizziness, fatigue for the past three days. She had no fever, cough, shortness of breath or dysuria. She had not been taking any oral hypoglycemic agents for many months as she was trying to control her diabetes with lifestyle modifications. However, after the passing of her husband three months prior, she became less motivated in managing her health. Ten days prior to her hospitalization, the patient was newly prescribed empagliflozin 10 mg daily by her primary care provider due to uncontrolled hyperglycemia. She refused to resume metformin due to her history of gastrointestinal intolerance. She was previously on glipizide, but this was not restarted as she previously had poor glycemic control on it. On arrival at the ER, her temperature was 97.9 F, heart rate 112 bpm, respiratory rate 22 bpm, blood pressure 105/63 mmHg, and pulse oximetry on room air was 97%. Physical exam was…
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