Euglycemic Diabetic Ketoacidosis Associated With SGLT2 Inhibitor Therapy: A Case Report

Klinkner, Gwen DNP, RN, BC-ADM, CDCES, FADCES
Steingraber-Pharr, Maggie MSN, RN, FNP-BC

Gwen Klinkner is Diabetes Clinical Nurse Specialist, University of Wisconsin Hospital and Clinics, 600 Highland Ave, MC 6736, Madison, WI 53792 ([email protected]).
Maggie Steingraber-Pharr is Nurse Practitioner on the Inpatient Diabetes Management Service, University of Wisconsin Hospital and Clinics, Madison, Wisconsin.

The authors declare no conflicts of interest.

AACN Advanced Critical Care 34(1):p 27-32, Spring 2023. | DOI: 10.4037/aacnacc2023830

ABSTRACT

Sodium-glucose cotransporter-2 inhibitors are now considered second-line treatment agents for type 2 diabetes and offer a unique treatment approach with added cardiorenal benefits. Drugs in this class increase the risk of euglycemic diabetic ketoacidosis, which may be difficult to diagnose if clinicians are not aware of the risk factors and subtle symptoms. This article describes a case of euglycemic diabetic ketoacidosis in a patient with coronary artery disease who was taking a sodium-glucose cotransporter-2 inhibitor and experienced acute mental status changes immediately after heart catheterization.