Case 16: A Case of Euglycemic Diabetic Ketoacidosis After Initiation of Ketogenic Diet in a Patient With Type 2 Diabetes on a Sodium–Glucose Cotransporter 2 (SGLT2) Inhibitor
Abstract
A 52-year-old Caucasian female with a past medical history of well-controlled type 2 diabetes, hypertension, and dyslipidemia presented to the emergency department with a 3-day history of severe headache associated with nausea, neck pain, and photophobia. Her outpatient diabetes regimen consisted of metformin 1,000 mg twice a day, linagliptin (a dipeptidyl peptidase-4 [DPP-4] inhibitor) 5 mg daily, and empagliflozin (a sodium–glucose cotransporter 2 [SGLT2] inhibitor) 25 mg daily. She reported starting a ketogenic diet 4 months before admission with an objective 17-lb weight loss after she had prior success with extremely low-carbohydrate/ketogenic diets in the past.
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