Ketoacidosis Due to Empagliflozin, a Paradigm Shift: Case Report and Review of Literature

Curr Diabetes Rev. 2019;15(4):259-262. doi: 10.2174/1573399814666180726114044.

Abstract

Introduction: Sodium-glucose cotransporter 2(SGLT2)-inhibitors are new antihyperglycemic agents that have shown a reduction in cardiovascular events in type 2 diabetes mellitus. Recent warnings have been developed about an increased risk of euglycemic and moderate hyperglycemic diabetic ketoacidosis with the use of SGLT2 inhibitors, but its real incidence is not available yet.

Case report: We present a case of DKA with moderate hyperglycemia in a patient treated with metformin and empagliflozin.

Conclusion: DKA in patients treated with SGLT2 inhibitors can be presented as euglycemic and moderated hyperglycemia. This special presentation poses a physician's challenge.

Keywords: SGLT2 inhibitors; Sodium glucose cotransporter 2; diabetes mellitus; diabetic ketoacidosis; empagliflozin; euglycemia..

Publication types

  • Case Reports
  • Review

MeSH terms

  • Benzhydryl Compounds / administration & dosage
  • Benzhydryl Compounds / adverse effects*
  • Blood Glucose
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetic Ketoacidosis / chemically induced*
  • Glucosides / administration & dosage
  • Glucosides / adverse effects*
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / adverse effects*
  • Male
  • Middle Aged
  • Sodium-Glucose Transporter 2 Inhibitors / administration & dosage
  • Sodium-Glucose Transporter 2 Inhibitors / adverse effects*

Substances

  • Benzhydryl Compounds
  • Blood Glucose
  • Glucosides
  • Hypoglycemic Agents
  • Sodium-Glucose Transporter 2 Inhibitors
  • empagliflozin