Euglycaemic DKA secondary to Canaglifozin, an easily missed diagnosis.
Acute Med. 2017;16(4):196-199
Authors: Bhatnagar RK, Kurera I, Perry R, Tringham J
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.
PMID: 29300799 [PubMed - in process]