Two cases of euglycemic diabetic ketoacidosis caused by dapagliflozin

Abstract

Hyperglycemia (Glucose> 250 mg/dL), metabolic acidosis (pH <7.3), ketosis (ketonemia or ketonuria) are stated as diagnostic criteria for diabetic ketoacidosis. Diabetic ketoacidosis can rarely be seen in blood glucose below 250 mg/dL. This condition is called euglycemic diabetic ketoacidosis. Although it is a rare condition, since a normal glucose level may exclude the diagnosis, it may cause a delay in treatment and consequently increase morbidity and mortality. Sodium-glucose co-transporter 2 (SGLT2) inhibitors are new generation oral anti-diabetic drugs used in the treatment of diabetes mellitus. It can cause rare but serious complications, such as euglycemic diabetic ketoacidosis. With these case reports, we aimed to raise awareness about euglycemic diabetic ketoacidosis.