Euglycaemic DKA secondary to Canaglifozin, an easily missed diagnosis
Bhatnagar, R.K.; Kurera, I.; Perry, R.; Tringham, J.
Acute Medicine 16(4): 196-199
2017
ISSN/ISBN: 1747-4892 PMID: 29300799 Document Number: 17317
Diabetic ketoacidosis (DKA) is a state of hyperglycaemia, ketosis and metabolic acidosis. This carries a significant morbidity and mortality particularly if left untreated or if the diagnosis is delayed. We present a case of euglycaemic DKA in a 48 year old female with non-insulin treated T2DM who had good glycaemic control. Initial investigations revealed moderate metabolic acidosis, persistent ketonuria and blood glucose levels < 11 mmol/l. There was a significant delay in diagnosing DKA following admission with multiple consultant reviews. Detailed history revealed the recent addition of Canagliflozin (SGLT2 inhibitor). This can rarely be a precipitant of euglycaemic DKA. With appropriate DKA treatment, rapid correction of acidaemia and ketosis occurred allowing her to be discharged home within 24 hours.
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