Euglykemische diabetische ketoacidose

Background

Sodium glucose cotransporter 2 (SGLT2) inhibitors are a relatively new class of oral antidiabetics. Euglycaemic diabetic ketoacidosis (DKA) is a rare, but potentially life-threatening side effect of these drugs. This side effect can be elicited by low supplies of carbohydrates.

Case description

We are describing 2 patients with type 2 diabetes mellitus who came to the emergency room with dyspnoea associated with partially respiratory compensated metabolic acidosis. The acidosis was found to be caused by euglycaemic DKA while using an SGLT2 inhibitor. Both patients were following a strict low-carbohydrate diet.

Conclusion

Patients and caregivers should – even if there are non-abnormal or slightly increased blood sugar levels – be watchful for the existence of DKA in patients who are taking SGLT2 inhibitors, as we expect these drugs to be prescribed more and more frequently.

Conflict of interest and financial support: none declared.