SAT110 Euglycemic Diabetes Ketoacidosis Associated With Sodium-glucose Cotransporter Inhibitors: A Case Series To Raise Awareness
Abstract
Abstract Disclosure: D. Katwal: None. Y. Pokharel: None. M. Ghawji: None. Z. Liu: None. H.O. Steinberg: None. S. Dagogo-Jack: Consulting Fee; Self; AstraZeneca, Boehringer Ingelheim, Janssen Research & Development Company, Medtronic Diabetes, Merck & Co., Sanofi, Bayer, Inc. Research Investigator; Self; AstraZeneca, Novo Nordisk, Boehringer Ingelheim. Other; Self; Janacare. Introduction: Sodium-Glucose Cotransporter Inhibitors (SGLT2i) treatment is increasing partly due to its cardiovascular and renal benefits, enlarging the population at-risk for euglycemic diabetic ketoacidosis (euDKA), a potentially life-threatening adverse event associated with SGLT2i use. Unfortunately, even among healthcare providers, awareness of euDKA appears to be low, resulting in delayed treatment and increased morbidity/mortality; We describe three cases of euDKA to illustrate. Case 1: A 25-year-old morbidly obese male with recent onset of T2DM presented with nausea and vomiting for two days. A few days before his presentation, he was started on dapagliflozin 5 mg daily and metformin 500 mg BID. Symptoms began within 24 hours of starting his medications. Laboratory results were consistent with euDKA: blood glucose (BG) of 144 mg/dl (70-110 mg/dl), pH 7.05 (7.35-7.45), bicarbonate 6 mmol/L (21-31mmol/L), and anion gap (AG) 20 mmol/L (2-15mmol/L). The euDKA resolved after 48 hours on standard treatment. Case 2: A 54-year-old male with T2DM on empagliflozin 10 mg daily presented with progressive…
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