Euglycemic diabetic ketoacidosis due to small bowel perforation: a case report
Abstract
Diabetic Ketoacidosis (DKA) is a potentially life-threatening condition that complicates diabetes mellitus. Euglycemic DKA (eDKA) is emerging as a variant in both type 1 and type 2 diabetes mellitus. The rise in its presentation is being caused by newer medicines using SGLT-2 inhibitors, with a complex underlying pathophysiology. Here we report a case of a 70-year-old woman presenting to the emergency department complaining of shortness of breath and abdominal pain. She suffers from type 2 diabetes mellitus and is on oral therapy, including the SGLT-2 inhibitor empagliflozin. Further testing revealed a high-anion-gap metabolic acidosis without elevation of lactate levels and a glucose level of 160 mg/dL. CT imaging of the abdomen showed a small bowel perforation. The case required aggressive medical therapy before surgical repair in the operating room. EDKA is a medical emergency that can be challenging to identify due to its atypical presentation compared to the traditional DKA (which is hyperglycemic). These characteristics can delay effective and timely treatment.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Strategy for Mitigating DKA Risk in Patients with Type 1 Diabetes on Adjunctive Treatment with SGLT Inhibitors: A STICH Protocol
- Glucoraphanin: a broccoli sprout extract that ameliorates obesity-induced inflammation and insulin resistance
- SGLT2 Inhibitors in Heart Failure: Targeted Metabolomics and Energetic Metabolism
- Mechanisms of blood pressure reduction with sodium-glucose co-transporter 2 (SGLT2) inhibitors
- Sodium-glucose cotransporter inhibitors: beyond glycaemic control
- Decoding the effects of SGLT2 inhibitors on cardiac arrhythmias in heart failure
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.