Sodium-glucose cotransporter-2 inhibitors induced euglycemic diabetic ketoacidosis: Two case reports and a review of the literature

Zouheir Ibrahim Bitar 1, Ossama Sajeh Maadarani 1, Fawaz Alabdali 2, Ahmed Teama 3, Walid Elsawah 3, Mohammed Jaber Mohsen 4, Mahmoud Mostafa Elzoueiry 4

Affiliations

02 October 2022

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doi: 10.1002/ccr3.5440

Abstract

If not detected early, euglycemic diabetic ketoacidosis can be a serious adverse effect of sodium-glucose cotransporter-2 (SGLT2) inhibitors. Unfortunately, euglycemic diabetic ketoacidosis is underreported in recent trials and missed because of normal blood sugar levels and nonspecific symptoms on presentation. We present two patients with type 2 diabetes mellitus who developed dapagliflozin-associated euglycemic diabetic ketoacidosis followed by hyperglycemic ketoacidosis. The second patient had euglycemic ketoacidosis twice despite instructions to stop using the medication dapagliflozin.

Keywords: SGLT2 inhibitors; dapagliflozin; ketoacidosis.

Conflict of interest statement

The author(s) declare no potential conflict of interest with respect to the research, authorship, and/or publication of this article.

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