Sodium-glucose cotransporter-2-induced euglycemic diabetic ketoacidosis unmasks latent autoimmune diabetes in a patient misdiagnosed with type 2 diabetes mellitus: a case report

J Med Case Rep. 2021 Feb 14;15(1):62. doi: 10.1186/s13256-020-02607-2.

Abstract

Background: Euglycemic diabetic ketoacidosis is an uncommon but life-threatening complication associated with the use of sodium-glucose cotransporter 2 inhibitors that causes lower than expected blood glucose levels typically seen in diabetic ketoacidosis.

Case presentation: We present a case of 64-year-old Caucasian male patient previously diagnosed with type 2 diabetes treated with a sodium-glucose cotransporter 2 inhibitor who developed severe ketoacidosis. Serum glucose levels on initial presentation were slightly above normal baseline level. The patient was revealed to have latent autoimmune diabetes in adults.

Conclusion: This case highlights the importance of prescribing sodium-glucose cotransporter 2 inhibitors to the correct patient population and the significance of accurately differentiating between various types of diabetes.

Keywords: Diabetic ketoacidosis; Latent autoimmune diabetes in adults (LADA); Sodium-glucose cotransporter 2 inhibitors (SGLT2i).

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Diabetes Mellitus, Type 1*
  • Diabetes Mellitus, Type 2* / diagnosis
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetic Ketoacidosis* / chemically induced
  • Diabetic Ketoacidosis* / diagnosis
  • Diagnostic Errors
  • Glucose
  • Humans
  • Male
  • Middle Aged
  • Sodium
  • Sodium-Glucose Transporter 2 Inhibitors* / adverse effects

Substances

  • Sodium-Glucose Transporter 2 Inhibitors
  • Sodium
  • Glucose