8084 Euglycemic Diabetic Ketoacidosis in Vulnerable Populations: A Case Series
Abstract
Abstract Disclosure: M.S. Shah: None. S. Humayon: None. R. Chawla: None. C. Peñaherrera: None. This case series explores seven cases admitted to a community hospital's inpatient and ICU services in 2023, with resident physicians closely managing their care. Our focus was to compare presentations and highlight risk factors contributing to Euglycemic Diabetic Ketoacidosis (euDKA). The following seven patients have a history of type 2 diabetes mellitus (DM 2) and were on SGLT-2 inhibitors for either diabetic management or goal-directed medical therapy (GDMT) for heart failure. These patients either presented with or developed euDKA during hospitalization. Diagnostic criteria used for euDKA being HCO3 ( 250 mg/dL) and Beta-hydroxybutyrate (>3 mmol/L). All patients were treated with an insulin drip. IV fluids were provided cautiously given multiple patients with reduced ejection fraction and lack of severe dehydration seen in euDKA. Mrs. E, a 57-year-old female with DM 2 (HbA1c of 9.7%), presented to the hospital for ST elevation M.I and subsequently started on GDMT for heart failure. Initiated on Dapagliflozin inpatient, leading to euDKA amid poor oral intake. Mr. L, a 54-year-old male with DM 2 presented to the ED with hyponatremia. On Empagliflozin per GDMT for heart failure. He presented with euDKA, attributed to prolonged fasting from chronic nausea. Hospital course complicated by cardiac arrest and AKI on CKD requiring CRRT. Mr. S, a 56-year-old male with DM 2 (HbA1c of…
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